Language
English (UK)
Welsh (Cymraeg)
Form 1:
Initial information for a DBS application
Full Name
*
First Name(s)
Last Name
Date of birth
*
Postal address
*
address
postcode
Email Address
*
example@example.com
Contact Number
-
Area Code
Phone Number
Name of the church
*
church name and town
town /village
Church denomination?
*
Please Select
Baptist Union of Wales
Union of Welsh Independents
Presbyterian Church of Wales
Other
I wish to complete my DBS application:
*
option A - ONLINE
option B - USING A PAPER DBS FORM
My role will involve working directly with:
*
children /young people
vulnerable adults
no direct work with children or vulnerable adults
Your role/ job title
*
Please Select
working or volunteering with children / young people
Sunday school teacher
Sunday school superintendent
pastoral visitor
trustee
deacon or elder
minister
other - give more details in the box below
If your role / job title is not included in the list above or if you do more than one role please add details below
Please give a brief outline of your direct work with children or vulnerable adults (If trustees do not do direct work they should note the children's /vulnerable groups activity in the church)
*
Role with ADULTS will involve ( tick all that apply):
*
transporting a vulnerable adult for health or social care (e.g.. to doctors / hospital
collecting an adult from a residential home
trustee in a church that has specific activities for children and /or vulnerable adults
assisting a vulnerable adult with shopping, bills or personal affairs
Personal care - assisting with feeding, dressing or hygiene
I do not work directly with vulnerable adults/ adults at risk
I regularly help with teaching, guiding or advising adults or give care, supervision
I regularly provide transport to adults on behalf of the church (other than for health care purposes e.e. to church services/activities)
How frequently do you carry out your role with adults?
*
Daily
Weekly
Monthly
Occasionally
no direct work
Roles with CHILDREN (tick all that apply):
*
I do not work directly with children
I transport a child/ children
I work with children in my own home
I work unsupervised with children
I lead an activity (unsupervised)
I supervise other children's workers
Personal care (prompting or helping young, ill or disabled children with eating/ washing/ toileting nappy changing
I will be working with children and will always be supervised
trustee in a church that has specific activities for children and /or vulnerable adults
How frequently do you carry out your role with children?
*
Daily
Weekly
Monthly
occasionally
no direct children's work
Will you be under constant supervision when working with children?
*
Yes
No
Is this DBS check for a
new role/postholder
an existing postholder
a renewal for an existing postholder
Is this DBS check for a
*
voluntary position
paid position
All applicants will need to meet with a verifier to show 3 identity documents. Please note the name of your local verifier (if known).
I have read the Panel Privacy Statement DBS ( https://panel.cymru/en/dbs) explaining how my information will be collected and used by the Panel and DBS
*
Yes
Thank you for completing this form. Please note this is NOT your DBS application form. If you have opted to complete your DBS electronically you will receive an email with a link and a password from Gwynedd Council. Please complete the form as soon as possible.
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