London175 Application Form

Note: Your privacy is very important to us. To better serve you, the form information you enter is recorded in real time.

By filling out this application form you are applying to become a participant on London175.

Programme*

First name*

Last name*

Country of residence*

Town/City*

Nationality*

We collect this information so we can better understand the reach of our programmes. It does not inform the selection criteria. If you do not wish to provide this information, please select ‘prefer not to say’

Primary email address*

Confirm Primary email address *

Alternate email address*

Mobile*

How did you first hear about Common Purpose?*

Please state

Data Protection – using your data

If accepted as a participant on a Common Purpose programme, Common Purpose may store and use your data to send you information relating to your programme and to request feedback.

To see our full Privacy and Data Protection Policy, please visit http://commonpurpose.org/privacy-data-protection-policy

There may be photographs and videos taken at the Common Purpose programme or event listed above to be used for commercial, knowledge sharing and evaluation purposes. If you would prefer not to be included in these, please notify a Common Purpose staff member during your programme or via email at marketing@commonpurpose.org

During the programme

We may publish your name and contact details strictly to members of your own participant group as part of any materials distributed to participants. If you do not opt in, your name will not appear on any programme information shared with your fellow participants.

I am happy for Common Purpose to share my information with participants of my programme*

Yes, I opt in No, I opt out

After the programme

Successfully completing a Common Purpose programme means you become an alumnus and will automatically receive our alumni newsletter.

The Common Purpose Alumni team may send you occasional email updates, including the Common Purpose quarterly newsletter.

I am happy for Common Purpose to send me alumni communications*

Yes, I opt in No, I opt out

Terms and conditions

I confirm that in signing this application I have read and understood the terms and conditions.

I understand that I have a commitment to attend the programme and that failure to do so may jeopardise my ability to graduate from the programme.

I have read and agree with the programme terms and conditions*

I agree

Tell us why you should be part of London175

You can choose to submit your answer in the form of a written answer, poetry, video or artwork.

Use the text box either to write your answer in a few sentences or supply a download link to a short video clip, piece of artwork, or poem (you can use services such as DropBox/WeTransfer etc).

We aim to make our programmes accessible to all, including for those who have a disability or face significant challenges due to health, well-being or personal circumstances. Please let us know if you may require adjustments to the programme.*

I may require adjustments to the programme I do not require adjustments to the programme

Please tell us about any reasonable adjustments you may need below

I will be between the age of 18-25 on the first day of the programme. *

I confirm

I identify my gender as*

Town/City*

Position/Job Title*

(if you are studying or unemployed – write ‘studying’ or ‘unemployed’)

Organization name*

(if you are studying – write the name of your educational institution)

Social media handles

Date*

Common Purpose is the data controller for the purposes of the EU General Data Protection Regulation 2018.

Except in connection with the activities described in the Privacy and Data Protection Policy or where required to do so by law, we will not disclose your data to third parties without your consent. Common Purpose takes all reasonable precautions to prevent the loss, misuse or alteration of your data. If you have queries relating to the use of your data, please email info@commonpurpose.org

We value diversity on our programmes and positively encourage applications from all sections of the community.

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