JOTI 2024 Safeguarding Referral Form

Please Note: This is an internal form for Network Volunteers Only, as a user or leader, please use the ‘Contact Us’ form to report concerns.

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Your Details
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Your Report
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Report Context
4
Details Of Concern
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Logging
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Last Page

Your Details

Please enter all details as this will help us deal with cases as swiftly as we can.

Your Name
First & Last
IRC Nick
Your Membership Number
If Applicable
Your National Scouting Organisation (NSO)
YOur Phone Number
Please include the Country Code e.g. +44 for UK
Your Email Address
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Your Details
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Your Report
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Report Context
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Details Of Concern
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Logging
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Last Page

Your Report

Please fill in this section to determine which version of the form we show you next.

Is Your Report Regarding…
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Your Details
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Your Report
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Report Context
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Details Of Concern
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Logging
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Last Page

Report Context

Please enter any known information regarding the persons involved

User Nickname
User Country
If you are an IRCop then please use the users IP to check the country they are from
User Whois
Please run /whois <NICK> and paste the entire response here
Are They a ScoutLink Volunteer?
Users First Name
Users Last Name
Age (Or Approximate)
Further Details
If you are aware of any further information regarding the person this report is about then please enter it here
Are They Aware The Concern/ Incident Has been Reported
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Your Details
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Your Report
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Report Context
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Details Of Concern
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Logging
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Last Page

Details of Concern

Please enter as much information as you have, logs will be submitted on the next page.

Date & Time of Incident or Concern
Approx.
date& time you were notified of the incident or cocnern
How did you become aware of this incident/ concern?
Where did this incident take place?
e.g. #english on ScoutLink IRC
What happend or what where you concerned about?
Please include as much information as possible
Do you have any previous concerns regarding this person?
Do you know how the person at risk is now?
Are you reporting this concern directly or have you shared details with anyone else?
Please Give Details of Who and When If You Have Shared It.
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Your Details
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Your Report
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Report Context
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Details Of Concern
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Logging
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Last Page

Logging

Please submit all logs – with timestamps, dates and channel names bellow. (e.g. In #english on 2024-12-27. Also include logs from where the incident has been discussed or elevated to other team members

PLEASE DO NOT LINK TO PASTEBINS OR OTHER UPLOAD SITES, INSTEAD PLEASE PASTE LOGS DIRECTLY INTO THIS FORM FEILD

Logs:
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Your Details
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Your Report
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Report Context
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Details Of Concern
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Logging
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Last Page

Privacy Statement

This form is used to collect information about you and others (including adults and young people) for the purpose of a safeguarding referral to be used by the Team at ScoutLink. The information you provide may include sensitive personal data or criminal data, which is necessary to ensure we have sufficient information for safeguarding purposes and can offer additional support if required to keep young people safe.

How Your Data Will Be Used:
We may contact you or others involved to seek further information.
Personal data collected in this form may be shared with appropriate third parties, including, National Scout Associations, statutory agencies, to ensure the safety and well-being of individuals involved.
The data will be securely stored by us on ScoutLink.net and ScoutLink Request Tracker.

Data Retention:
Your information will be retained for a maximum of 1 year after the case has been closed by the relevant safeguarding authority.

Your Rights:
For more information on how we protect your data and how you can exercise your data rights, please refer to our Data Protection Policy – https://www.scoutlink.net/privacy/

If you have any questions relating to the use of your data please contact jcc@scoutlink.net.

By submitting this form, you consent to the use of the data provided in accordance with these terms.