Membership and Activity Registration Form

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First Name *

Last Name *

Date of Birth *

YYYY

Gender

Male

Female

Prefer not to say

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Address *

Postcode *

Telephone Number

Ethnic and Cultural Background

Black British

Black Other

Dual Heritage

White British

White Other

Asian British

Asian Other

Other ( Please State)

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If other, please state:

Sexual Orientation

Hetrosexual

Gay

Lesbian

Other

Prefer Not To Say

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Faith/Religious Observance

Christian

Jewish

Sikh

Muslim

Hindu

None

Other

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Education/Employment Details

Full Time Education

Full Time Employment

Other Education

Other Employment

Gov Supported Training

Not in Education, Employment Training

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Emergency Contact Information - Name and Telephone number. *

Do you have a disability or require special medical assistance? (Allergies or any other medical condition) *

How did you hear about us? *

SkyWay Website

Social Media

Schools

SkyWay Flyer

Word of Mouth - Family/Friends

Other:

Data may be stored on an electronic database in compliance with the Data Protection Act 1998

You do not have to provide all of the above information but it will contribute to our equal opportunities monitoring. It is collected in order to monitor the diversity of people we work with and to compile statistics to show our funders and others how we are doing. For this reason some of the information we take about you may be shared with other services. We will agree with you what information will be shared.

If you have any query about the use we make of your data, please contact SkyWay on 020 7729 6970 or by e-mailing info@skyway.uk.com.

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