I'm interested in the SEND and Inclusion Youth Board

Young person's name:

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Young person's date of birth:

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This is to help to check the ages of young people who are interested, so we can work out how best to put you into groups.

Please tell us about anything we can do to support you with taking part for example, captions in video calls:

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This information helps us to plan accessible and inclusive sessions, where everyone can take part fully.

Please tell us about any interests or skills you have. What are you good at? What topics do you know most about?

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This helps us to plan interesting sessions and match you to projects you might enjoy taking part in.

Please tick any things you are interested in:

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A safe online chat forum

Online group meetings and video calls

Face to face group meetings

One to one or small group chats

Online projects I can do in my own time, without going to any meetings

Other (please specify)

This helps us think about how to set up activities and groups.

Please tell us a little bit more about you. Tick all the options that you feel apply to you:

* required

I prefer to do things by myself

I feel pretty confident in a group situation

I like being part of a group but, sometimes I need a bit of support to take part

I am comfortable taking the lead in a group

I like online meetings and group calls

I like face to face groups

I can feel anxious in a group situation or with new people

I love being in a group and chatting to people

I'm not sure

I feel OK doing presentations and speaking in public if I've prepared what to say

I want to tell you something else about myself...

This helps us to send you information on the projects you might most enjoy and help you to take part.

Please tick all that apply:

* required

Please send me some more information by email

Please contact me to arrange a phone call or video call , so I can find out more

Other (please specify)

Young person's or contact email address

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If you are under 16, please give us a parent or carer's contact details. An email address and/or phone number, plus their name please.

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