Referee Submission Form

Name of Applicant *

First Name Last Name

Appointment under consideration

Group / Unit *

Membership Number of Applicant (if known)

Please add details of two* people to act as referees who are known to the applicant and who can be contacted by email. The referees should preferably have knowledge of the applicants work or contact with young people, and should be able to comment on the applicants character and relationships with others. At least one referee should have known the applicant for at least five years and one of the referees must not be from Scouting. Referees must not be relatives. Examples of referees include your employer, college tutor etc.

* If you have been asked to supply only one name then please select 'GSL Reference' for Referee 2.

Referee 1 - Name *

First Name Last Name

Email address for Referee 1 available

Yes No

Referee 1 Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Referee 1 email *

Referee 2 - Name *

First Name Last Name

Email address for Referee 2 available

Yes No GSL Reference

Referee 2 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Referee 2 email

As part of the Appointment process you will be asked to attend an Appointments Meeting. Please provide your availability below. *Note that a Monthly meeting is held on the 4th Thursday of the Month (January to July, September to November). Other dates are provided when the demand dictates. Saturdays and Sundays would normally occur at District/County Events.

Appointments Meeting Availability *

	Monday	Tuesday	Wednesday	Thursday*	Friday	Saturday*	Sunday*
Available to Attend
My Scouting Night
NOT available

Your Full Name *

First Name Last Name

Date *

Day Month Year

Your E-mail *

We will use this information to contact you should we need to
clarify any of the Referees details.

Enter the message as it's shown *