Member Information Update

To help make sure we hold accurate information about you, please complete the following short form:

    Your full name:

    Your preferred email address:

    Contact phone number:

    Next of Kin (ICE) name:

    Next of Kin (ICE) phone number:

    The Trust asked us all to complete a Volunteer Data Form in March. What is the status of your form?

    Do you have a new-style NHS DBS ID card? (example)

    Ahead of our return to live programming, have you had the Covid Vaccination?

    Have you completed a Gift Aid form?

    I consent to Southend Hospital Radio holding my personal data electronically:

    I consent to my contact data being shared with the MSE Trust:

    Any other information: