BIRMINGHAM PARENT CARER FORUM
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PARENT CARER REPRESENTATIVE APPLICATION FORM
This form is for those parent carers who wish to apply for the voluntary role of Parent Carer Representative with BPCF.  Please answer the questions below as fully as you can. If completing a paper application please attach additional information as needed.
Full Name *
Address *
Email Address *
Telephone / Mobile Number *
To be a Parent Carer Representative you need to have a child/Young Person under the age of 25 with SEND - please state your child/YP age and needs *
Why do you want to be a Parent Carer Representative? *
What skills and experience would you bring to the role? *
What areas are you passionate about (e.g. transport, school exclusions etc.)? *
How much time are you able to commit to the role as a Parent Carer Representative?   *
Do you speak any additional languages? If so, which ones? *
What geographical area of Birmingham are you able to cover? *
Is there any other information you would like to add, or questions you'd like to ask?
Birmingham Parent Carer Forum will use the information you provide on this form to consider and get in touch with you regarding your application. Please tick the box below to indicate your preferred contact method(s). *
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You can change your mind at any time and request that we remove your information from our database by emailing us at info@birminghampcf.org. We will treat your information with respect and it will remain within BPCF Management Committee and its staff. For more information about our privacy practices please visit our website at www.birminghampcf.org . By clicking below, you agree that we may process your information in accordance with these terms. *
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