Scotty's Membership Form

We know that completing forms can feel difficult, especially during emotional times. We’re here to make this as easy as possible, so if you have any questions while completing this Membership form, please just get in touch. Here are our contact details. WhatsApp or call on 07741 162132 or email us families@scottyslittlesoldiers.co.uk

Scotty Members are:

Children and young people aged 0-25 who have had a parent, who served in the British Armed Forces, die or be diagnosed with a terminal illness.

Veteran or still serving.
From any branch of the Armed Forces (RAF, Navy, Army etc)
The death or illness was or wasn't attributed to service. It doesn't matter at Scotty's.

We know families come in all shapes and sizes and can sometimes be complicated.

Scotty’s supports children who are:

Biological
Adopted
Stepchildren
Estranged
Living with the parent or not.

Whatever their story, they are welcome at Scotty’s.

If you are a professional completing this form with a family’s consent, please enter the family’s details into the relevant sections. When asked who is completing the form, please select or name the person who has given consent for you to help.

Are you joining Scotty's because...

Someone in the family has died.Someone in the family has been diagnosed with a terminal illness.

Who is filling out this form?

I am the parent or carer of the child(ren) or young peopleI am a young person applying for my own membership (age 18-25).

I am completing this form for...

One childTwo childrenThree childrenFour childrenFive childrenSix children or more

About me (if you are a professional helping a family complete a form, please write the details about the parent or carer with responsibility for the child(ren) here)

My first name

Enter your preferred first name or nickname if you have one and would prefer Scotty's to call you by this name instead.

My surname

My date of birth

My address

My postcode

My email address

My mobile number

My relationship to the child(ren)

MumDadLegal Guardian (or in the process of applying)Other

If other, please pop the relationship in here

My gender is

MaleFemaleOther

This question helps us understand if we are reaching people equitably. My ethnicity is

Asian or Asian BritishBlack, Black British, Caribbean or AfricanMixed or multiple ethnic groupWhiteOther ethnic group

What was your relationship to the person has been terminal diagnosed or died? We know how complicated families can be so we ask this question to try and get a better understanding of your unique family dynamics so we can provide the best help and support.

Husband / WifePartnerFriendEx Other

If other, please pop the relationship in here

If you connect or identify with any religion, please let us know here so that we can offer support in line with your beliefs, practice or faith.

Please upload something to confirm your name and address. This could be a picture of a utility bill, bank letter, a driving license, or any other official doc.

About me

My first name

Enter your preferred first name or nickname if you have one and would prefer Scotty's to call you by this name instead.

My surname

My date of birth

My address

Postcode

My phone number

My email address

My gender is

MaleFemaleOther

My relationship to my parent who has been terminal diagnosed or died?

StepchildAdoptedBiologicalOther

If other, please give details here

This question helps us understand if we are reaching people equitably. My ethnicity is

Asian or Asian BritishBlack, Black British, Caribbean or AfricanMixed or multiple ethnic groupWhiteOther ethnic group

If you connect or identify with any religion, please let us know here so that we can offer support in line with your beliefs, practice or faith.

Please upload something to confirm your name and address. This could be a picture of a utility bill, bank letter, a driving license, or any other official doc.

We sometimes send our members edible gifts like chocolates or sweets, so if you have any dietary requirements please note them here.

If you have any special educational needs or disabilities (self diagnosed is also okay!) or any other relevant conditions or needs, please let us know here, that way we can make sure we send appropriate gifts or make appropriate access arrangements for events.

Next of Kin or emergency contact full name

Next of Kin or emergency contact relationship to you

Next of Kin or emergency contact relationship to the person who has been terminal diagnosed or died?

Husband / WifePartnerEx ParentIn lawFriendThey didn't know themOther

Next of Kin or emergency contact phone number

Next of Kin or emergency contact email address

About my child

Their first name (please add a nickname or preferred name in brackets if they have one)

Enter you childs preferred first name or nickname if they have one and would prefer Scotty's to call them by this name instead.

Surname

Date of birth

Their gender is

MaleFemaleOther

Their relationship to the parent who has been terminal diagnosed or died?

StepchildAdoptedBiologicalOther

If other, please pop the relationship here

This question helps us understand if we are reaching people equitably. My child's ethnicity is

Asian or Asian BritishBlack, Black British, Caribbean or AfricanMixed or multiple ethnic groupWhiteOther ethnic group

If your child connects or identifies with any religion, please let us know here so that we can offer support in line with their beliefs, practice or faith.

We sometimes send our members edible gifts like chocolates or sweets, so if your child has any dietary requirements, please note them here.

If your child has any special educational needs or disabilities (self diagnosed is also okay!) or any other relevant conditions or needs, please let us know here, that way we can make sure we send appropriate gifts or make appropriate access arrangements for events.

About my next child

Their first name

Enter you childs preferred first name or nickname if they have one and would prefer Scotty's to call them by this name instead.

Surname

Date of birth

Their gender is

MaleFemaleOther

Their relationship to the parent who has been terminal diagnosed or died?

StepchildAdoptedBiologicalOther

If other, please pop the relationship here

This question helps us understand if we are reaching people equitably. My child's ethnicity is

Asian or Asian BritishBlack, Black British, Caribbean or AfricanMixed or multiple ethnic groupWhiteOther ethnic group

If your child connects or identifies with any religion, please let us know here so that we can offer support in line with their beliefs, practice or faith.

We sometimes send our members edible gifts like chocolates or sweets, so if your child has any dietary requirements please note them here.

About my next child

Their first name

Enter you childs preferred first name or nickname if they have one and would prefer Scotty's to call them by this name instead.

Surname

Date of birth

Their gender is

MaleFemaleOther

Their relationship to the parent who has been terminal diagnosed or died?

StepchildAdoptedBiologicalOther

If other, please pop the relationship here

This question helps us understand if we are reaching people equitably. My child's ethnicity is

Asian or Asian BritishBlack, Black British, Caribbean or AfricanMixed or multiple ethnic groupWhiteOther ethnic group

If your child connects or identifies with any religion, please let us know here so that we can offer support in line with their beliefs, practice or faith.

We sometimes send our members edible gifts like chocolates or sweets, so if your child has any dietary requirements please note them here.

About my next child

Their first name

Enter you childs preferred first name or nickname if they have one and would prefer Scotty's to call them by this name instead.

Surname

Date of birth

Their gender is

MaleFemaleOther

Their relationship to the parent who has been terminal diagnosed or died?

StepchildAdoptedBiologicalOther

If other, please pop the relationship here

This question helps us understand if we are reaching people equitably. My child's ethnicity is

Asian or Asian BritishBlack, Black British, Caribbean or AfricanMixed or multiple ethnic groupWhiteOther ethnic group

If your child connects or identifies with any religion, please let us know here so that we can offer support in line with their beliefs, practice or faith.

We sometimes send our members edible gifts like chocolates or sweets, so if your child has any dietary requirements please note them here.

About my next child

Their first name

Enter you childs preferred first name or nickname if they have one and would prefer Scotty's to call them by this name instead.

Surname

Date of birth

Their gender is

MaleFemaleOther

Their relationship to the parent who has been terminal diagnosed or died?

StepchildAdoptedBiologicalOther

If other, please pop the relationship here

This question helps us understand if we are reaching people equitably. My child's ethnicity is

Asian or Asian BritishBlack, Black British, Caribbean or AfricanMixed or multiple ethnic groupWhiteOther ethnic group

If your child connects or identifies with any religion, please let us know here so that we can offer support in line with their beliefs, practice or faith.

We sometimes send our members edible gifts like chocolates or sweets, so if your child has any dietary requirements please note them here.

About my next child

Their first name

Enter you childs preferred first name or nickname if they have one and would prefer Scotty's to call them by this name instead.

Surname

Date of birth

Their gender is

MaleFemaleOther

Their relationship to the parent who has been terminal diagnosed or died?

StepchildAdoptedBiologicalOther

If other, please pop the relationship here

This question helps us understand if we are reaching people equitably. My child's ethnicity is

Asian or Asian BritishBlack, Black British, Caribbean or AfricanMixed or multiple ethnic groupWhiteOther ethnic group

If your child connects or identifies with any religion, please let us know here so that we can offer support in line with their beliefs, practice or faith.

We sometimes send our members edible gifts like chocolates or sweets, so if your child has any dietary requirements please note them here.

If you have more than six children, please add the names of your other children here along with their date of birth and any additional needs or considerations etc.

About your parent who died

We are sorry to have to ask such personal questions in this section. We know how painful it can be, but it is important that we have as much of this information as possible. If you do not know all the answers to some of the questions, please just complete what you can or get in touch with us at families@scottyslittlesoldiers.co.uk.

What is their first name?

What is their surname?

What is their date of birth?

What is their date of death?

When they died were they...

still servinga veterannot sure

Service

ArmyRAFNavyRoyal MarinesArmy reservistRAF reservistRoyal Navy reservist

Their military rank? (If you know it)

Their service number (if you know it)

How did they die?

Illness or heart relatedSuicideAccidentKilled in actionMissing/declared deadOther

If other, please add a note here.

If you have it, please upload something that confirms the person had served in the British Armed Forces. If you don’t have this, that’s absolutely fine — we can help to find this information for you.

If you have it, please upload something that confirms the person has died. If you don’t have this, please don't worry — we can help to find this information for you.

We may need to contact trusted organisations such as, Armed Forces Disclosures, Joint Casualty and Compassionate Centre (JCCC), Defence Business Services (DBS), Vets UK or other relevant services to gain proof of service and proof of death as we recognised that not everyone will have this information to hand. Please write your full name in the box below to confirm that you’re happy for us to share your name, and the details of the person who has died (this section of the form) so we can obtain this information for you.

If there is anything else you think it would be helpful for us to know, please put it here. This could include anything about the circumstances around the death, or complicated family relationships (or if your parent had other children who you think we could help). Scotty's is a judgement free, safe space.

About the parent who died

What is their first name?

What is their surname?

What is their date of birth?

What is their date of death?

When they died were they...

still servinga veterannot sure

Service.

ArmyRAFNavyRoyal MarinesArmy reservistRAF reservistRoyal Navy reservist

Their military rank (if you know it)

Their service number (if you know it)

How did they die?

Illness or heart relatedSuicideAccidentKilled in actionMissing/declared deadOther

If other, please pop a note in here

If you have it, please upload something that confirms the person has died. If you don’t have this, please don't worry — we can help to find this information for you.

If there is anything else you think it would be helpful for us to know, please put it here. This could include anything about the circumstances around the death, or complicated family relationships (or if the parent who died had other children who you think we could help). Scotty's is a judgement free, safe space.

About your parent who is ill

What is their first name?

What is their surname?

What is their date of birth?

When were they diagnosed?

When they were diagnosed were they...

still servinga veterannot sure

Service

ArmyRAFNavyRoyal MarinesArmy reservistRAF reservistRoyal Navy reservist

What was/is their military rank?

If you know their service number please add it here.

We may need to contact trusted organisations such as, Armed Forces Disclosures, Joint Casualty and Compassionate Centre (JCCC), Defence Business Services (DBS), Vets UK or other relevant services to gain proof of service as we recognised that not everyone will have this information to hand. Please write your full name in the box below to confirm that you’re happy for us to share your name, and the details of the person who is ill (this section of the form) so we can obtain this information for you.

Please tell us what you know about the illness and anything else that might be helpful for us to understand.

About the parent who is ill

What is their first name?

What is their surname?

What is their date of birth?

When were they diagnosed?

When they were diagnosed were they...

still servinga veterannot sure

Service

ArmyRAFNavyRoyal MarinesArmy reservistRAF reservistRoyal Navy reservist

What was/is their military rank?

If you know their service number please add it here.

We may need to contact trusted organisations such as, Armed Forces Disclosures, Joint Casualty and Compassionate Centre (JCCC), Defence Business Services (DBS), Vets UK or other relevant services to gain proof of service as we recognised that not everyone will have this information to hand. Please write your full name in the box below to confirm that you’re happy for us to share your name, and the details of the person who is ill (this section of the form) so we can obtain this information for you.

Please tell us what you know about the illness and anything else that might be helpful for us to understand.

Final little bits! You are nearly done!

How did you hear about Scotty's?

Visiting Officer or Welfare teamInternet search/social media/newspaperFriends/familyAnother Scotty familyHospiceAnother charity/organisationOther

If other, please pop a comment here as we would love to know.

Data Protection (GDPR) Scotty’s make every effort to store your data/images and video footage securely and takes data protection very seriously. Our main storage solutions are provided by Microsoft and Salesforce, two of the leading data organisations globally. We are also a digitally led organisation and do not keep any paper copies of information long-term. All data is kept in accordance with UK, EU and International law. Depending on what services you access you may be asked again to sign additional consent forms regarding the storage and use of your data. We will not share your personal data with other organisations without your explicit permission. Please note, we share fully anonymised, unidentifiable data with other organisations such as our funders for the purpose of reporting on our impact and the needs of the community. We share fully anonymised, unidentifiable data with other organisations for research purposes with the aim of contributing to the evidence base regarding the needs of our community. We share fully anonymised, unidentifiable data publicly where Scotty’s has undertaken research with the aim of building society’s understanding of the needs of our community. Please tick below to show you have read and understood, and agree to our use of your data. Please also tick if you would like us to email you copies of our our full GDPR and privacy statement policies.

I have understood and consent to Scotty's use of my dataI consent but would like Scotty's to send me a copy of their full GDPR policy

If you would also like to recieve a copy of our safeguarding policy please tick here.

I would like to recieve a copy of Scotty's safeguarding policy.

Declaration: Scotty’s Little Soldiers is a registered charity that relies entirely on charitable donations to support bereaved children and young people whose parent served in the British Armed Forces.

Because our support is funded by charitable donations, it is important that we have written confirmation that every new member is eligible for our services. Please tick here to confirm that all the information provided in this form is true and correct.

I confirm that the information in this application form is true and correct.

Contact Information