Intro and about you

General points
 
• Please answer all questions. If you think some parts do not apply to you or you are not comfortable sharing this information, write N/A (not applicable) in the spaces provided for your answer.
• We can help you fill in the form or complete it over the phone if you are unsure or need any support – please get in touch at askme@womensaid.org.uk. 

Women’s Aid Federation of England are delivering the ask me scheme in partnership with your local domestic abuse service. The information you provide on this form, including your personal details, will be used to sign you up to the training course. Women’s Aid Federation of England will contact you to follow up with your application.

To carry out the training, we may share your personal details including your name, job or volunteer title with delivery partners.

Women’s Aid Federation of England will also use the provided information in these forms for the purposes of evaluating the scheme. This is for us to see what works well, does not work so well and make any improvements. All information will be kept confidential, anonymised and analysed altogether rather than individually. This means it will not be possible to identify any personal details or any one person from any information you provide. This will feed into reports, which will be published on our website and shared with funders and partners.

In the areas of Surrey, Sunderland, Nottingham and Nottinghamshire the scheme will also be analysed by external evaluators from the University of Central Lancashire (UCLAN). This means that anonymised data will be shared with researchers at UCLAN for these areas only.

To understand more about how we will use your data please read our Privacy Policy: https://www.womensaid.org.uk/privacy-cookie-policy/

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* 1. I consent to my information being used for evaluation purposes.

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* 2. Full Name

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* 3. Town/ city

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* 4. Postcode

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* 5. Contact Number

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* 6. Date of Birth

Date / Time

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* 7. Email address

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