Join the Winston's Wish Youth Team!

What is your age group?

12 years or under13-25 years

Which role are you interested in?

Youth AdvisorYouth AmbassadorBoth / not sure

About you - young people aged 13-25

First name

Last name

Preferred pronoun

Date of birth

Please use dd/mm/yyyy format

What is you main language

Ethnicity

Ethnicity Origin - other (please specify)

Do you consider yourself to have any special education need/s or disability?

If yes, please tell us more

Which gender do you identify with?

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

Date of birth

Please use dd/mm/yyyy format

What is you main language

Ethnic origin

Ethnic origin - other (please specify)

Which gender do you identify with?

Gender - other (please specify)

Do you consider yourself to have any special education need/s or disability?

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

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

Join the Winston's Wish Youth Team!

Hearing from us