Duplicate certificate request form

Duplicate certificate request form

IMPORTANT NOTES:

Please try to avoid using the auto fill function on this form because when you start to fill in the ‘Your details’ section it may override the ‘Certificate recipient details’ section with your own details.

The purpose of this form is to request from the UK Headquarters Scout Awards Team a duplicate certificate for any of the following that have previously been awarded:

• Good Service awards

• Length of Service awards

• Meritorious Conduct awards

• Gallantry awards

• Cornwell Scout Badge

• Chief Scout’s Personal Award

• Wood Badge

If you require a Length of Service Award that is not showing on your membership profile, then please use this form - https://app.smartsheet.com/b/form/c16a435f9cf44229a8d99eb7c320f016

This form is used to collect personal data about you and the certificate recipient. We take the obligation for personal data privacy seriously. The data you provide to us is handled and retained in accordance with our Data Protection Policy: https://www.scouts.org.uk/about-us/policy/.

Upon receipt of the request, the UK Headquarters Scout Awards Team will aim to action this within 28 working days unless otherwise specified.

Certificate recipient details

The details below should be those of the person to be named on the certificate.

Membership number*

Please include any 0's at the front of a membership number. For example, if the membership number is 0006789, please enter 0006789. If the certificate is for a youth member please type in 'Youth'. If the individual is from a Branch (and therefore does not have a membership number) please write ‘BRANCH in the box below.

First name*

Please copy this exactly from the membership system.

The name printed on a certificate will be as per the 'Certificate Name' listed on membership system.

If the individual is not on the membership system, whatever is typed in this box is what will then be printed on the duplicate certificate. This includes where you have/haven't used capital letters, middle names and spaces.

Surname*

Please copy this exactly from the membership system.

The name printed on a certificate will be as per the 'Certificate Name' listed on membership system.

Award type*

Select

Is a certificate required?*

If you only need a badge/brooch/medal/wood beads, please select 'No'.

Select

Is a badge/brooch/medal or wood beads required?*

Select or enter value

Date on certificate*

Please copy this exactly from the membership system. Whatever is typed in this box is what will then be printed on the duplicate certificate.

Wood Badge role

This is only required if the request is for a duplicate Wood Badge Certificate.

Wood Badge number (If known)

This is only required if the request is for a duplicate Wood Badge Certificate. If you do not know the Wood Badge number, leave blank and we can try and find this for you.

County (England) / Area (Wales) / Region (Northern Ireland/Scotland), or Region, or Country*

Select

District*

If this member is not part of a District, please select N/A.

Select

Reason for duplicate request*

Select

Does this award need adding to members profile?*

If the award is already on a members profile, please select 'No'. If the award is not on a members profile, please select 'Yes'.

Select or enter value

Your details

The details below should be those of the member who is requesting the duplicate certificate and who the duplicate need to be sent to. If there are any issues with the request, we will contact you regarding it.

Please note, we normally send the award out to the correspondence address listed on the membership system. If you wish for this award to be sent elsewhere, then please detail this to the notes section.

IMPORTANT NOTE: Please do not use the auto fill function on this form because when you start to fill in the ‘Your Details’ section it may override the ‘Certificate recipient details’ section with your own details.

Role*

If your role is not an option, then you will need to ask someone who does have permission to request this duplicate.

Select

Membership number*

Name*

Do you want to send this award to someone else?*

Select or enter value

Membership number of who this should be sent to:*

Please note, we will send the Award to their correspondence address listed on the membership system.

Name of who this should be sent to:*

Please note, we will send the Award to their correspondence address listed on membership system.

Notes

Please list below any other relevant details relating to this request.

(If your request is due to the current certificate being incorrect, please detail here what was incorrect on the certificate.)

Send me a copy of my responses

Privacy Notice|Report Abuse