24th World 2019 Durham County Contingent Application Form

All parts to be completed in full, and signed by

• The applicant, Name: • The applicant’s parent or legal guardian, Troop/Unit • The applicants section Leader. District

Checklist:

Before completing the application form, complete the following checklist to ensure that you are eligible to attend the 24th :

Please tick ¨ Born between 22nd July 2001 and 21st July 2005 (inclusive). ¨ Currently either a Scout or Explorer Scout in Durham Scout County. ¨ Able to attend the selection day on Saturday 14th or Sunday 15th October at Moor House. ¨ Able to raise the necessary funds (£3,000+) by a combination of fund raising, self-funding and support from your /Unit and Scout District ¨ Be able to pay a deposit of £280 by Friday 24th November 2017 ¨ Able to pay instalments during 2018 and 2019 ¨ Willing to abide by the Selection Code of Conduct below

Selection Code of Conduct

Potential Unit members are expected to: þ Be organised and on-time for the selection event, þ Do as you are asked and do what you say you are going to do, þ Have fun, but behave in a responsible manner when required, þ Work as part of a team.

Note that the Unit members will develop a more complete Code of Conduct once selected.

Photograph

Please affix a recent photograph, so that we can put a face to the name during the selection day

24th World Scout Jamboree 2019 Durham County Contingent Application Form

A: Personal Details

First Name(s): Surname: ………...……………………………………… ………...……………………………………… Address: Prefer to be ………...……………………………………… known as: ………...……………………………………… Date of Birth: ………...……………………………………… ………...……………………………………… Telephone Number: ………...……………………………………… ………...……………………………………… Postcode: Email Address: ………...……………………………………… ………...……………………………………… School: Religion: ………...……………………………………… ………...……………………………………… Scout/Explorer District: Group: ………...……………………………………… ………...……………………………………… What night does your Troop or Unit meet? ………...………………………………………

B: The Jamboree Please write a short paragraph explaining why you want to participate in the World Scout Jamboree 2019:

Tell us how you will benefit from attending the World Scout Jamboree in the USA:

Tell us how other people will benefit from you attending the World Scout Jamboree in the USA:

Tell us how you will be funding a place to attend the World Scout Jamboree in the USA:

C: Experience Tell us about any large camps, international camps or other international experiences you have previously taken part in

What is your favourite Scouting Experience to date?

D: Interests Outside of Scouting Please List any hobbies or interests that you have:

Give details of any non-Scouting awards gained such as First Aid Certificates or for Sports.

E: References Give us the names of two people who can tell us more about you (but not your family):

Name Role / Position Telephone number E-mail address

F: Applicant’s Declaration I agree that as part of this application to join the Durham World Scout Jamboree Unit: • I need to be an active member a Scout Troop / Explorer Unit from now until after the Jamboree • I need to make every effort to take part in all training camps and fundraising before the Jamboree and debriefing presentations after the event. • I have included a photograph of myself.

I have told my leader that I am applying. I understand that you may contact him/her before you confirm whether I have been selected for the Unit

Signature of Applicant: Date:

……………………………………………………………….. …………………………………………………….

G: Signature of Parent / Guardian Photographs will be taken from time to time of Unit members during training activities and the Jamboree itself. These may be published in print or on Scout websites to promote the Unit’s activities. This will always be in accordance with the Policies of .

Please tick this box if you agree to your child’s photographs being used in this manner

• I fully support this application. I realise that I may be asked to help with fundraising events for the whole Unit and I will help when needed. I will also ensure that payments are made by the required dates. • I give permission for my son / daughter to take part in any events or camps leading up to the Jamboree and the Jamboree itself.

Signature of Parent / Guardian:

……………………………………………………………………………………………

Please Print Name: …………………………………………………….. Date: ..…………………………………………

H: Section Leader’s Signature Confirmation of the applicant’s current membership of Durham Scout County

Signature of Scout / Explorer :

……………………………………………………………………………………………

Please Print Name: …………………………………………………….. Date: ..…………………………………………

PLEASE RETURN TO: 24th World Scout Jamboree 2019, Durham County Scouts, Moor House Adventure Centre, Rainton Gate, Houghton-le-Spring, Tyne & Wear, DH4 6QY