Join the Winston's Wish Youth Team!
What is your age group?
12 years or under
13-25 years
Which role are you interested in?
Youth Advisor
Youth Ambassador
Both / not sure
About you - young people aged 13-25
First name
Last name
Preferred pronoun
Please select...
He/him/his
She/her/hers
They/them/their
Ze/hir/hirs
Xe/xem/xyrs
Ver/vir/vis
Te/tem/ter
E/em/eirs
Other
Date of birth
Please use dd/mm/yyyy format
What is you main language
Please select...
English
Arabic
Bengali
Chinese
French
Gujarati
Panjabi
Polish
Portuguese
Spanish
Urdu
Other
Ethnicity
Please select...
White - English/Welsh/Scottish/Northern Irish/British
White - Irish
White - Gypsy or Irish Traveller
White - Roma
White - Any other White background
Mixed - White and Black Caribbean
Mixed - White and Black African
Mixed - White and Asian
Mixed - Any other Mixed/multiple Ethnic background
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Asian or Asian British - Bangladeshi
Asian or British Asian - Chinese
Asian or Asian British - Any other Asian background
Black or Black British - African
Black or Black British - Caribbean
Black or Black British - Any other Black background
Other - Arab
Other - Any other ethnic group
Prefer not to say
Skip
Ethnicity Origin - other
(please specify)
Do you consider yourself to have any special education need/s or disability?
Please select...
Yes
No
Prefer not to say
If yes, please tell us more
Which gender do you identify with?
Please select...
Woman
Man
Non-binary / Gender non-conforming
Prefer to self define
Prefer not to say
Other
Gender - other
(please specify)
Your Doctors surgery details
(We will only contact your doctor if we are concerned about you and your mental health and are unable to contact you)
How can we best support you in the Youth Team application process
(please tell us about any access requirements you may have for written or digital communication)
:
About you - children aged 12 and under
Please ask a parent or guardian to fill out this application form with you. We want to know all about you, but as you are under 13, we will make contact with your parent or guardian about your application.
First name
Last name
Preferred pronoun
Please select...
He/him/his
She/her/hers
They/them/their
Ze/hir/hirs
Xe/xem/xyrs
Ver/vir/vis
Te/tem/ter
E/em/eirs
Other
Date of birth
Please use dd/mm/yyyy format
What is you main language
Please select...
English
Arabic
Bengali
Chinese
French
Gujarati
Panjabi
Polish
Portuguese
Spanish
Urdu
Other
Ethnic origin
Please select...
White - English/Welsh/Scottish/Northern Irish/British
White - Irish
White - Gypsy or Irish Traveller
White - Roma
White - Any other White background
Mixed - White and Black Caribbean
Mixed - White and Black African
Mixed - White and Asian
Mixed - Any other Mixed/multiple Ethnic background
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Asian or Asian British - Bangladeshi
Asian or British Asian - Chinese
Asian or Asian British - Any other Asian background
Black or Black British - African
Black or Black British - Caribbean
Black or Black British - Any other Black background
Other - Arab
Other - Any other ethnic group
Prefer not to say
Skip
Ethnic origin - other (please specify)
Which gender do you identify with?
Please select...
Woman
Man
Non-binary / Gender non-conforming
Prefer to self define
Prefer not to say
Other
Gender - other (please specify)
Do you consider yourself to have any special education need/s or disability?
Please select...
Yes
No
Prefer not to say
If yes, please tell us more
Your Doctors surgery details
(We will only contact your doctor if we are concerned about you and your mental health and are unable to contact you)
How can we best support you in the Youth Team application process
(please tell us about any access requirements you may have for written or digital communication):
About your parent/carer and contact details
Parent/carer's first name
Parent/carer's last name
Preferred pronoun
Please select...
He/him/his
She/her/hers
They/them/their
Ze/hir/hirs
Xe/xem/xyrs
Ver/vir/vis
Te/tem/ter
E/em/eirs
Other
Relationship to the child
Parent/Carer's phone number
Parent/Carer's email address
Parent/Carer's Street
Parent/Carer's Town/City
Parent/Carer's County
Parent/Carer's Postcode
Your contact details
Email address
Mobile number
Postal Street
Town/City
County
Postcode
Have you previously accessed support from Winston's Wish?
Yes
No
If you feel able to, please tell us about your experience of grief and bereavement
Which of the following areas are you interested in getting involved with? (Please tick as many as you wish)
Creating content for other grieving young people (art, poetry, music, video, podcasts etc)
Sharing your story to inspire others
Sharing your opinions to help make services better
Meet other grieving young people
Take over our social media
Write for our website
Appear in the media
Represent us at events
Get involved with fundraising initiatives
Be involved in interviews and shortlisting for new members of staff
Get involved in delivering new projects
Help to create new resources and materials
Work alongside staff members and share skills
Other
Please tell us
Which of the following areas are you interested in getting involved with? (Please tick as many as you wish)
Sharing things that have helped you with others
Sharing your story to inspire others
Tell us what you liked about your support and what we could change to make it better
Get involved with fundraising
Work on projects with other children and young people
Help us to create new resources
Test and give feedback on our resources and activities
Share your art, writing, poetry and music with others
Share how Winston's Wish has helped you
Tell us a little about why you'd like to be part of the Winston's Wish Youth Team
Where did you hear about the Winston's Wish Youth Team?
Please select...
Facebook ad
Instagram ad
YouTube ad
TikTok
Winston's Wish website
Other website
Winston's Wish email
Other email
Word of mouth
Other
Please tell us
Do you want to stay in touch?
We would like to send you updates on the latest news, events and information about the Youth Team. Please opt in below to receive these updates. If you don't opt in, we will only contact you with information specifically relating to your application to join the Youth Team.
Yes, I would like to receive updates
No, please only contact me with information specifically relating to my application
How would you like to hear from us?
Yes, I would like to hear from Winston's Wish by Email
Yes, I would like to hear from Winston's Wish by Post
Yes, I would like to hear from Winston's Wish by Phone
Yes, I would like to hear from Winston's Wish by SMS
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