Join the Junior Youth Team

Join the Winston's Wish Youth Team!

What is your age group?

12 years or under13-25 years

Which role are you interested in?

Youth Advisor (Applications currently closed)Youth Ambassador (Applications currently closed)Both / not sure

About you - young people aged 13-25

First name

Last name

Preferred pronoun

Date of birth

Please use dd/mm/yyyy format

Ethnicity

Ethnicity Origin - other (please specify)

Which gender do you identify with?

Gender - other (please specify)

Your GP's details (We will only contact your GP if we are concerned about you and your mental health and are unable to contact you)

About you - children aged 12 and under

Please ask a parent or guardian to fill out this application form with you. We want to know all about you, but as you are under 13, we will make contact with your parent or guardian about your application.

First name

Last name

Preferred pronoun

Date of birth

Please use dd/mm/yyyy format

Ethnic origin

Ethnic origin - other (please specify)

Which gender do you identify with?

Gender - other (please specify)

Your GP's details (We will only contact your GP if we are concerned about you and your mental health and are unable to contact you)

About your parent/carer and contact details

Parent/carer's first name

Parent/carer's last name

Preferred pronoun

Relationship to the child

Parent/Carer's phone number

Parent/Carer's email address

Parent/Carer's Street

Parent/Carer's Town/City

Parent/Carer's County

Parent/Carer's Postcode

Become a Junior Youth Ambassador!

As a Junior Youth Ambassador, you can:

What happens next?

Join the Winston's Wish Youth Team!

Do you want to stay in touch?

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