Form 1:

Form 1:

Initial information for a DBS application
Full Name*

First Name(s)Last Name
Postal address*

addresspostcode
Email Address*
example@example.com
Contact Number

Area CodePhone Number
Name of the church *

church name and town town /village
Church denomination?*
I wish to complete my DBS application:*

option A - ONLINEoption B - USING A PAPER DBS FORM
Will your role involve working directly with*

Children/ young people?Vulnerable adults / adults at risk?None?
Your role ?*
Please give a brief outline of your direct work with children or vulnerable adults (Trustees should note the church's activities with vulnerable groups).*
Will your role with ADULTS involve :

Personal care (help with dressing/ toilet etc)Assisting with money /shoppingtransporting an adult for health or social care (eg. to doctors / hospitalcollecting an adult from a residential home?none of the above
How frequently do you carry out your role with adults?

DailyWeeklyMonthlyOccasionally
Will your role with CHILDREN involve (tick all that apply):

Personal care (prompting or helping young, ill or disabled children with eating/ washing/ toileting nappy changing)?Transporting a child?working with children in your own home?unsupervised work with childrenleading an activitysupervising children's workersnone of the above
How frequently do you carry out your role with children?

DailyWeeklyMonthlyOccasionally
Is this DBS check for a

new role/postholderan existing postholdera renewal for an existing postholder
Is this DBS check for a*

voluntary positionpaid 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).
Should be Empty:

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