Youth Empowerment Board registration form Survey

1.Name(Required.)

2.Telephone number(Required.)

3.Email address(Required.)

4.Full address (with postcode)

5.Date of birth

6.School / college

7.Tell us why you want to join the Youth Empowerment Board(Required.)

8.Are you happy to join the YEB WhatsApp Group? Note: your number will be visible to the other YEB members

Yes

9.I confirm (tick √)

I want to join the Youth Empowerment Board

I have read the Youth Empowerment Board Values

I am committed to the Values of the Youth Empowerment Board

I commit to attend all Youth Empowerment Board Meetings unless I have a valid reason for not attending

10.Signature

11.Please note: your personal data is being collected for record keeping purposes, and will not be shared with third parties outside of Poplar HARCA.

A privacy notice is on the Poplar HARCA website, explaining in greater detail what we will and will not use your data for.(Required.)

Please confirm that you have read, agreed to the privacy notice by ticking here

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