Angels Membership Application Form

In accordance with GDPR, individual data collected will only be accessed by Angels Support Group DBS checked staff and will not be passed onto any third party or published publicly with any details which could potentially identify a family. The information will be used solely to compile statistics to enable us to obtain further funding, to complete monitoring for current funding and to ensure our services continue to meet the needs of our members. For more information please read our Privacy Policy.

    I consent to Angels holding my data for these purposes

    I understand that as part of my membership to Angels Support Group I will be asked to complete 3 joining surveys in the first year of my membership and will be asked to complete other feedback surveys and vote for the Angels AGM annually. This information is essential for our charity to continue to run.

    Surname of Parent*

    First Name*

    Street Address*

    Address Line 2

    Town/City*

    County*

    Postcode*

    Country*

    Telephone / Mobile*

    I consent to Angels contacting me by telephone or text YesNo

    Email*

    I consent to Angels contacting me by email YesNo

    We send most of our information to you by email. If you have selected that you don’t want to receive emails from us, we just want to check how you would like to hear from us. For cost reasons we can't send all the emails out to you by post but we can send the termly programme, details of holiday activities and other important information relating to your membership of Angels if you would like us to.

    I consent to Angels sending me information by post YesNo

    Ethnic Background*

    Do you consider yourself to have a disability? YesNo

    Please give details

    Do you have, or consider yourself to have ADHD and/or Autism? YesNo

    Your Diagnosis - Autism DiagnosedADHD DiagnosedAutism AwaitingADHD AwaitingAutism Self DiagnosedADHD Self Diagnosed

    Surname of Child*

    First Name of Child*

    Date of Birth*

    Gender MaleFemale

    Child's Diagnosis - ASCADHDASC and ADHDAwaiting ASCAwaiting ADHDAwaiting ASC and ADHD

    Any other diagnoses - please describe

    GP Surgery*

    School*

    Please give details of any other children in the family as they are welcome to attend any events that Angels run.

    Sibling One's Name

    Sibling One's Date of Birth

    Gender MaleFemale

    Sibling One's School

    Sibling One - details of any special needs

    Sibling Two's Name

    Sibling Two's Date of Birth

    Gender MaleFemale

    Sibling Two's School

    Sibling Two - details of any special needs

    Sibling Three's Name

    Sibling Three's Date of Birth

    Gender MaleFemale

    Sibling Three's School

    Sibling Three - details of any special needs

    Any other information you feel is relevant

    Please tell us how you heard about Angels Support Group

    If you’re having trouble with this online form you can download the manual form here –

    Download Form