Joining the Youth Voice Network

1 of 2 How to join

Please confirm that you live in England or Wales *

Yes, I live in England or Wales

First name *

Surname *

Name you like to be called (if different)

Date of birth *

Young person email address *

Young person phone number *

Are you under 16 years old *

Yes

The first name of your parent or legal guardian *

The surname of your parent or legal guardian *

What is their relationship to you? *

Parent or legal guardian phone number *

Parent or legal guardian email address *

Parent or legal guardian postcode *

Legal guardian address line 1

Legal guardian address line 2

Legal guardian Town / City

Legal guardian County

Legal guardian Country

Is your address the same as your legal guardian? *

Yes

Please enter your current postal address below

Young person postcode *

Young person Address 1

Young person address line 2

Young person Town / City

Young person County

Young person Country

Do you live in England or Wales? *

England

Wales

Language preference

English

Welsh

What is your gender?

Female

Male

Non-binary

Prefer not to say

Another / prefer to self-describe

Please specify *

Do you identify as trans?

Yes

Prefer not to say

What is your sexual orientation?

Gay man

Gay woman/lesbian

Heterosexual / straight

Prefer not to say

Another / prefer to self-describe

Please specify *

Are you happy to share your ethnic background?

Yes I would be happy to share

No I would prefer not to say

Asian or Asian British

Bangladeshi

Chinese

Indian

Pakistani

Black/Black British

African

Caribbean

Another Black background

Another Black background (please specify if you wish)

Mixed

White and Asian

White and Black African

White and Black Caribbean

Another mixed background

Another mixed background (please specify if you wish)

White or White British

White British

White Irish

Eastern European

Another White background

Another white background (please specify if you wish)

Other ethnic group

Arab

Gypsy or Traveller

Another background (please specify if you wish)

Another background - please specify if you wish

Do you speak Welsh?

Yes

Another (please specify if you wish)

Which of the following best describes your current living arrangement?

Home owner / occupier

Living in rented accommodation

Living in social housing / housing association

Living in sheltered / supported accommodation

Live with family or friends

Any other (please specify if you wish)

Prefer not to say

Any other (please specify if you wish)

Do you have a long-term health condition or learning difference that has a substantial or long-term impact on your ability to carry out day to day activities? For example, cerebral palsy, arthritis, deafness, visual impairment, severe depression, schizophrenia, cancer, multiple sclerosis.

Yes

Prefer not to say

What best describes your experience of mental health problems?

I have personal experience of mental health problems
I use / have used mental health services
I am a family member of somebody who has experienced mental health problems
I am a friend to someone who has experienced mental health
I care or look after someone who has mental health problems
Another (please specify if you wish)
None of the above

Another (please specify if you wish)

2 of 2 How we handle your data

Yes

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Last name *

Email address *

Joining the Youth Voice Network

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