St John Scotland Community Defibrillator Application

Community Defibrillator application

We help save lives across Scotland by providing advice, training, and funding to communities wishing to install a Public Access Defibrillator
In Scotland, around 70 people suffer a cardiac arrest every week. It is vital that someone begins CPR as soon as possible to give them the best chance of survival. Being able to use defibrillator within the first few minutes of collapse increases that chance even further.

We support organisations, clubs, communities, and individuals across the country to install Public Access Defibrillators and increase awareness of CPR in the hope of saving lives together.

Through our Community Defibrillator Scheme St John Scotland will:
- help identify the most suitable location for your defibrillator.
- set you a fundraising target of £1,000 for a defibrillator and external storage cabinet, and we will cover the remaining costs.
- offer advice and support around installation and guardianship of the PAD.
- deliver CPR and defibrillator awareness training for your community after installation.
If your application is successful, your organisation or community group agrees to:
- Take ownership of the defibrillator and/or cabinet (PAD).
- Have the cabinet installed by a qualified electrician.
- Register your defibrillator on 'The Circuit' https://www.thecircuit.uk/
- Regularly check and maintain your new PAD equipment.
- Replace consumables such as pads or batteries when required.
- Appoint a 'guardian' to look after the PAD and update the 'circuit' as required.
Our volunteers will discuss all the above with and support you with your PAD.

Please take your time to complete each section fully. Click on the headings below to add more detail to your application.

Contact defibs@stjohnscotland.org.uk if you have any questions.
Your details
1. Name of group, or individual, applying for support purchasing PAD equipment
Address of group, or individual (please add town or village where group operates in if no specific address)
Include building numbers or names and relevant street /road or local area
City / Town / Village
Please enter your nearest village, town or city
Postcode
2. Local authority area
3. Your name

First NameLast Name
4. Your position or relationship to community group
5. Your email address
example@example.com
6. Your phone number
7. Additional contact email address for community group, if you have one
Emails will be sent to your address above and also to any addresses you enter here.
Click on the heading below to open up the next section and questions.
- 8. Address of proposed location of PAD
  
  Address 1
  
  Address 2
  
  City / Town / VillageCouncil area
  
  Postcode
- SJS work in partnership with what3words (W3W) - software that divides the world into three-by-three metre squares, each with a three-word address. It is free and used by the majority of the UK emergency services. W3W provides a unique and precise location for the PAD installation.
  
  Click on this link to try - what3words
- 9. What3Words code for the proposed location of your PAD.
  Please go to what3words.com or download the app to pinpoint the proposed location
- 10. Why do you think this is the most suitable location for your new PAD?
- 11. Do you know where the nearest current Public Access Defibrillator is to your proposed location?
- 12. Whose electricity supply will be used to power the cabinet?
  There is a trickle charge of around £30 annually
- 13. It would help process your application if you upload images of the proposed location.
  
  Maximum of 3 images in any of the following formats: pdf, jpg, jpeg or png
  Cancelof
- Click on the heading below to open up the next section and questions.
- It is possible to apply for the following: -
  - defibrillator only,
  - defibrillator and cabinet, or,
  - cabinet only.
  *SJS promote the use of unlocked cabinets. However, we appreciate that some applicants may wish to determine which one they would prefer.
- 14. Please select which equipment you are hoping to install
- 15. Please confirm that you agree that your equipment will be
- 16. If you did not check one or more of the boxes above, please tell us why
- Click on the heading below to open up the next section and questions.
- A suggested donation of £1000 will contribute to the cost of the defibrillator and cabinet, with SJS covering the remainder.
- 17. What is/was your fundraising target?
- 18. Please indicate your community group's current status at time of application:
- 19. When do you hope to have raised your target amount?
  
  DayMonthYear
- 20. Please provide some brief details of your plans or methods for fundraising
  If you would like some advice on effective methods other groups have used, please let us know. Do also let us know if you are installing a defibrillator in memory of someone.
- Click on the heading below to open up the next section and questions.
- St John Scotland volunteers in your area will support your application and arrange suitable CPR and defibrillator awareness session(s).
  
  This is a fantastic opportunity to engage with the local community and tell them how essential it is for all of us to know CPR.
  
  Our CPR Awareness sessions are intended to give everyone the confidence to carry out CPR and use a defibrillator - saving lives together.
- 21. Are you able to organise and/or host a CPR and defibrillator training event with St John Scotland volunteers and your local community?
  Please include details of who you would invite to the CPR training from your local community.
- 22. Potential local venues for CPR Training
  This will help our volunteers plan for your session with you.
- 23. We would be delighted to publicise your PAD to promote interest in installing more throughout Scotland. Please let us know if there's anyone our Comms and Marketing team should liaise with.
- Click on the heading below to open up the next section and questions.
- Please provide delivery details to speed up ordering if your application is successful.
- 24. Delivery Address
  
  Address 1
  
  Address 2
  
  City / Town / VillageCouncil area
  
  Postcode
- 25. Delivery recipient's name
  
  First NameLast Name
- 26. Delivery recipient's email address (for delivery company notifications)
  example@example.com
- 27. Delivery recipient's phone number
- Click on the heading below to open up the next section and questions.
- Your new PAD must be registered on The Circuit - National Defibrillator network so the emergency services can direct callers to the nearest PAD and used in an emergency. It is essential that all PADS are registered on the Circuit.
  
  You, or your organisation (or local community group), agree to take ownership of the defibrillator and cabinet and will be responsible for the installation of the cabinet by a qualified electrician and any planning considerations. You also agree to check and maintain the PAD regularly (monthly) and agree to replace pads and batteries as necessary (as the Guardian of the PAD).
  
  Our local St John Scotland volunteers will work with you or your organisation to arrange CPR and defibrillator awareness sessions once the equipment has been installed.
- 30. Do you agree that if your application is successful, you (or your organisation) are committing to become guardians of this public access defibrillator (PAD) including being responsible for regularly checking the PAD as well as replacing items as required, and registering the device on The Circuit?
- 28. Date
  
  DayMonthYear
- 29. If you have already spoken to someone from St John Scotland about your application, please enter their name(s) here:
- 30. Where did you hear about St John Scotland's Community Defibrillators?
- 31. Privacy
  
  We take your privacy seriously and will only process your personal data with your consent and in accordance with our Privacy Policy. We will hold your data in accordance with Data Protection laws.
- 31. a)
- 31. b)
- 31. c)
- 32. Please verify that you are human
- For internal use only
- Should be Empty:

Community Defibrillator application

Your details