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Basic Information

Please select a title.
Please provide your title.
Please provide your first name.
Please provide your last name.
Please provide your street address.
Please provide your street address.
Please provide your city or town.
Please provide your county.
Please provide your post code.
Please provide your phone number.
Please provide your mobile number.
Please provide your email address.

Child with Additional Needs

Please provide your relationship to the child.
Please provide the child's name.
Please provide the child's date of birth.
Please provide the child's school.
Please provide the child's diagnosis.
Please provide the child's diagnosis.

Involvement

Please tick the boxes if you would like to be involved with YPCF in any of the following ways.

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Please tell us how you would like to be involved.
Please tell us how you heard of YPCF.
Please tell us how of any other memberships.

YPCF communicates with members in a number of ways, the regular newsletter, e-mail, Facebook and Twitter. We are reviewing the way we communicate with members, would you therefore please indicate your preferred method(s) of communication.

Please indicate.
Please provide your Twitter username.

York Parent Carer Forum complies with the Data Protection Act (1998). By ticking this box this membership form you are agreeing that York Parent Carer Forum will hold your information in line with its Data Protection policy. We will not share the information you provide with anyone else without your consent. For a full copy of our data protection policy visit our website yorkparentcarerforum.org.uk

Please agree to the terms.

Monitoring Information

YPCF aims to be an equal opportunities organisation. We want to encourage parents and carers from all sections of the community to get involved. To help us to do this we ask all members to provide this information. It is completely confidential and is not shared with anyone else.

If there are any questions you do not wish to answer please tick the “prefer not to say” box.

Carer: What is your ethnic group?

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Please specify.
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The Disability Discrimination Act 1995 (DDA) defines a person as disabled if they have a mental or physical impairment, which has a substantial and long-term (i.e. has lasted or is expected to last at least 12 months) and has an adverse effect on their ability to carry out normal day-to-day activities.

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