Personal Details

School/Youth Organisation

Image consent

In accordance with the Data Protection Act 1998 and GDPR, we need your permission before any photos and audio/visual recordings of you are used in promotional materials. We will not share images or audio/visual recordings taken of you with any external organisations, unless you give us permission to do so.
I give/do not give(delete as appropriate) my permission for images and audio/visual recordings of me to be used by Healthwatch Blackburn with Darwen using images (photo and video) of me in its printed publications websites and social media sites, for information, advertising, marketing and promotional purposes.

Supporting statement

Please let us know one professional person e.g. teacher, youth worker, employer or family friend who can write a statement supporting your application
Thank you for your interest in volunteering for Amplify and for spending time completing this form.