Membership Application

Disability (please complete this section if you have a disability or impairment). This will allow us to ensure we can adapt to meet your needs

If Yes, please check the type of impairment which applies to you. If you experience more than one type of impairment please indicate more than one.

Physical ImpairmentSensory ImpairmentMental Health Condition Learning Disability/Difficulty Long Standing Illness Other

The information you enter into this form will be collected and stored by Black Trans Alliance. Tick the tickbox below to confirm you understand. (required)

I understand

We will always store your personal details securely. We’ll use them to process your membership application, and communicate with you in the way(s) that you have agreed to. Your monitoring data details will be used for analysis purposes, to help us provide the best service possible. For full details see our Privacy Policy:- https://blacktransalliance.eu.rit.org.uk/privacy-policy

Membership Application

Monitoring Information (help us to understand the community and to serve you better)

Ethnicity (please indicate which ethnic group you consider yourself to belong to)

Disability (please complete this section if you have a disability or impairment). This will allow us to ensure we can adapt to meet your needs