CONFIDENCE WORKSHOP WITH MERSEYSIDE POLICE

For students under 18yrs, parents/guardians are to fill in applicant details (section 1) on behalf of the students then give their details (section 4) and sign.

1. APPLICANT DETAILS

NAME *

First

Last

GENDER

Male
Female

DATE OF BIRTH *

Full Address and Postcode

PHONE *

HOME PHONE

EMAIL *

2. ETHNICITY BACKGROUND

SELECT OPTIONS

3. APPLICANT EMERGENCY DETAILS

NAME *

First

Last

RELATIONSHIP TO THE APPLICANT

EMERGENCY CONTACT PHONE NUMBER

EMAIL *

4. PARENTS/GUARDIAN / ORGANISATION COMPLETING ON BEHALF OF THE STUDENT MUST GIVE THEIR DETAILS BELOW

If you are completing this form on behalf of a student under the age of 18, please provide your details below. By submitting this form with your information, you are legally signing on behalf of the minor. Please also state the relationship you have with student.

NAME *

First

Last

Full Address and Postcode

PHONE *

EMAIL *

CONSENT *

By ticking this checkbox, you are giving your consent for BAME HUB-UK NETWORK C.I.C & Funders to keep your data and information but must comply with UKGDPR 2020 legislation, the Freedom of Information Act 2000 or any UK or English legislation, statutory instrument, former EU directive or regulation now in force in the UK, or international law, in the way they handle and disclose information. By ticking the checkbox, you are also giving your consent for BAME HUB-UK NETWORK C.I.C and Funders to use your information in the following ways: broadcast channels such as websites, social media, e-newsletters, printed and electronic materials (flyers, leaflets, brochures, banners etc.) and media releases paid for advertising such as billboards, bus stops, buses, digital marketing, magazines, newspapers, radio, TV, and websites. Images and associated personal information will be held securely and will only be used by BAME HUB-UK NETWORK C.I.C. and Funders of the organisation or third parties with relevant consent obtained. Images of historical value may be held indefinitely in the public record.

Terms and Conditions Apply *

Once enrolled, you must comply with our terms and conditions

For students under 18yrs, parents/guardians are to fill in applicant details (section 1) on behalf of the students then give their details (section 4) and sign.

1. APPLICANT DETAILS

2. ETHNICITY BACKGROUND

3. APPLICANT EMERGENCY DETAILS

4. PARENTS/GUARDIAN / ORGANISATION COMPLETING ON BEHALF OF THE STUDENT MUST GIVE THEIR DETAILS BELOW

BAME HUB-UK NETWORK C.I.C.

WE CAN HELP

We Are Here For You

CONNECT WITH US