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Which Age Better in Sheffield project would you like to apply to be involved with?*

Please tick one project in the first list at this stage, you can be involved in other projects later on.

If you are not sure, tick here if you would like us to phone you to talk through your options.

I would like to be contacted by Age Better in Sheffield

Age Friendly City

If you are over 50 and would like to be involved in work to make Sheffield an Age Friendly City, to create or attend more local and citywide events, or to find out about our peer researcher programme, sign up here to find out more.

Age Friendly
Peer research

About you

Name*

First Last

Date of birth

MM

DD

YYYY

Address

Street Address Address Line 2 City County Postcode Country

Contact Number*

Email

Please tick your preferred means of contact

Phone
Email
Post
Text

Do you need support with reading or writing?

Tick all that apply

Difficulty reading
Difficulty writing
Limited English reading or writing skills
No English reading or writing skills
Translation services required
No difficulty
Prefer not to say

What languages do you speak?

Is there anything else that you would like to tell us?

This includes any special access requirements or risks

How did you find out about Age Better? Please tick ALL options that apply

Sharing information agreement

Your involvement with Age Better in Sheffield is of a confidential nature and information you share with us will normally be kept within the programme and only given to others with your permission.
However, information may be shared with the relevant statutory authorities without permission in the following circumstances:
• If we are required to do so by law
• If there is risk of significant harm to you and/or someone else
• If there are child/adult protection concerns

Personal Information*

I agree for South Yorkshire Housing Association to hold and use my personal information to take part in the Age Better in Sheffield programme until June 2022.

Yes
No

Sharing Information*

I agree for South Yorkshire Housing Association to share my details with partner organisations delivering Age Better in Sheffield projects in order to take part in the project(s) I have applied to join

Yes
No

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To get involved with our projects complete this online form and join the thousands of people who have taken part, and continue to enjoy them.

About you

Sharing information agreement