Become a Pelican — The Pelican Project

Become a Pelican Project member

Please only submit this form when you have spoken to one of our team.
You can contact us here:

Please complete the Registration Form below

We ask for the following information so that:

- we can begin the process of getting to know you
- we can contact you about the activities you are interested in
- we can evaluate our activities, helping us and our funders know that we
are making a difference. This also supports future funding
opportunities.

Full name

First Name

Last Name

This form has been completed with the support from the primary care giver of this individual

Name of primary care giver

Date of Birth

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Telephone Number

If you are completing this form on behalf of someone who does not use verbal communication, how best can we record their experiences?

For example photos, videos, facial expressions, advocacy from family members

What is your education history?

Tell us about any social care or educational provision or work you are part of.

Who will support you at The Pelican Project?

Please let us know if you plan to come independently

Photo Consent

Consent to use photos or film footage of Pelican Project members, staff and volunteers. To comply with General Data Protection Regulation 2018, we need your permission before we can photograph or capture any film or audio footage of you. I give permission for my photograph and any audio and film footage to be used - During presentations about The Pelican Project’s work - In printed materials promoting The Pelican Project’s services and fundraising events, campaigns and appeals - On The Pelican Project website - On The Pelican Project’s social media (Instagram, Facebook and Twitter) - In the local and national media to raise awareness of The Pelican Project’s work

Yes

This form has been completed with the support from the primary care giver of this individual

Name of Primary Caregiver

I understand that by completing this form I am consenting to The Pelican project sharing this information with Pelican group leaders and organisers.

We won’t share your information with anyone outside of The Pelican project.

I understand

Date

YYYY