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By completing this form you agree to SensationALL storing the data given and using it to assist in the provision of appropriate support and services. (NB: we will never share your details with any third parties unless you request us to do so.)
Are you registering a Service user or are you a Volunteer?*
Service user’s first name*
Service user’s last name*
Service user’s preferred name (optional)
Service user’s date of birth*
Service user’s gender*
Service user's pronouns*
Emergency contact name*
Email address*
Phone number*
Alt phone number
Emergency contact’s relationship to service user*
Service user’s communication ability*
Service user’s education setting
Service user’s residence setting*
First line of address*
Second line of address
Town/city*
Postcode*
For the following conditions select ‘Diagnosed’ if the condition has been formally diagnosed by a certified professional or select ‘Suspected’ if the condition is suspected, but not yet diagnosed. If neither apply, select no
Autism Spectrum Disorder
ADHD
Aspergers
Pervasive Demand Avoidance
Oppositional Defiant Disorder
Dyslexia/Dyspraxia/Dyscalculia/Dysgraphia
Speech and Language Issues
Developmental Delay
Learning Difficulties
Sensory Processing Disorder
Tourettes/Tics
Genetic Condition
Foetal Alcohol Spectrum Disorder
Epilepsy
Physical Disability
Mental Health issue
Personality Disorder
Other Diagnosed
Are there any allergies we need to be aware of that may affect the Service User while they are at SensationALL? (If yes, you will be sent a separate form to complete.)*
Do you give us permission to publicly use images of the named Service User? A copy of our full media policy can be provided on request to info@sensationall.org.uk*
How did you hear about us?*
Do you wish to receive our newsletter?*
When necessary, different agencies may seek information from other professionals or organisations providing support services to an individual. All agencies will keep information strictly confidential in accordance with their procedures. Are you happy for appropriate information to be shared with appropriate agencies that we work with such as Local Authority, Healthcare Professionals and Social Work only if required?*
First name*
Last name*
Date of birth*
Mobile number*
Please tell us why you are interested in volunteering at SensationALL*
Do you have any support needs or conditions that may affect your volunteering? (NB: declaring a condition will not exclude you from volunteering but allows us to fully support you in your volunteer role.)*
Emergency contact first name*
Emergency contact surname*
Emergency contact phone number*
Are you available on weekends?*
Are you available during the day on weekdays?*
Are you available during the evening on weekdays?*
We occasionally use images of our volunteers online, on our social media accounts and in marketing materials to promote volunteering at SensationALL. Do you consent to us using your image in this way?
Do you wish to receive our newsletter?