WAVE Trauma - Mental Health and Wellbeing Workshops.

1
Please select the workshop/s you would like to sign up for.You can select multiple workshops
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Name* This field is required.
First Name
Last Name
3
Address* This field is required.
Street Address
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Contact Number* This field is required.
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Email* This field is required.
example@example.com
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Armagh City, Banbridge and Craigavon Borough Council and Peace IV may take and use photo/videos recordings for reporting/advertising. Do you give permission to be photographed and or filmed? * This field is required.
YESNO
7
The Council, which you are submitting this information to, collects data for the purposes of the management and delivery of the PEACE IV Programme. The PEACE IV Programme is delivered through the Council’s Community Development Department. Personal data submitted for purposes of the Community Development Department functions will be retained securely and in line with Council’s Records Retention and Disposal Schedule. We will not disclose your personal data to other persons or organisations, however we may have to disclose where a disclosure is required by law.* This field is required.
I agree
8
With regard to the Community Development Department Database, are you happy to have your information / personal details included on the database to receive information from ABC Council which relates to the Community Development matters. * This field is required.
YESNO
9
PEACE IV MONITORING SECTION

We would like to know more about you. All information provided on this section is used for the purposes of the PEACE IV programme and will be kept confidential.
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What is your gender?* This field is required.
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What age are you? * This field is required.
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What is your community background?* This field is required.
CNR (Catholic/ Nationalist / Republican)
PUL (Protestant / Unionist / Loyalist)
BAME (Black / Asian / Minority / Ethnic)
Other
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