Eligibility:

Participant’s D.O.B should be between April 2002 and February 2010.

Fee:

£40 (non-refundable)

The Queen’s Award must be completed before the participant’s 25th birthday.

First name

Last name

District no

Captain Email

Minister Email

Address Line 1

Address Line 2

Town/City

Postcode

Tel.

Mobile

Please provide a mobile contact number

Email

Please read the following declaration statement carefully. The applicants themselves must read and complete the below declaration as appropriate.

DECLARATION STATEMENT

The data collected on this form is held for the sole purpose of GBNI and will not be distributed to any third party organisations. GBNI only requires the requested personal information for making contact for any GBNI related business. Records will be kept securely on file at GBHQ until no longer required after which point these forms will be destroyed. All participants have the ‘right to be forgotten’ and can send a request into GBNI to check what details has been stored about them. However, due to any potential child protection, health and safety or security issues, information may need to be retained for a period of 30 years, if GBNI deems this necessary.

To understand more about how GBNI collects and processes data to be compliant with GDPR, please refer to our privacy policy on the GBNI website.

IF YOU CONSENT TO PERSONAL DETAILS BEING STORED IN THIS MANNER PLEASE SIGN AND DATE BELOW.
(PLEASE REFER TO NOTES ABOVE).

Signature

Undo

For completion by parent/guardian if participant is under 18 years of age at application.

I give permission for my daughter to take part in all activities associated with the completion of the Queen’s Award. I give permission for my daughter to be contacted by GBHQ as required during completion of the Queen’s Award programme. Communication regarding the Queen’s Award programme may be made by telephone, letter, email and text message using the details provided overleaf (including WhatsApp).

Parental consent name

Signature

Undo