Marketing and Fundraising Consent form

Contact Information and Preferences

You can always change how we contact you. If you need to update your details or preferences, please get in touch with us at any time:

• Email: info@bibic.org.uk
• Phone: 01458 253344
• Post: bibic, Old Kelways, Somerton Road, Langport, TA10 9SJ

Marketing and Fundraising Consent form

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Assessment Attendee Full Name(Required)

Name of person completing this form

To be filled out by person with parental or carer responsibility. If over 18 not required.

Relationship to individual (if applicable)

Parent/carer

Marketing Consent

We’d like to contact you with information following. Please choose your preferences below.

Consent to be contacted by our Marketing Department, please select all that apply.(Required)

Seminars/Webinars

Family newsletter

All of the above

None of the above

We will use your contact details to keep you informed about the above activities. You can change your preferences at any time by emailing us at info@bibic.org.uk or calling 01458 253344.

Fundraising Consent

We rely on donations to fund our assessments and support families. We would like your permission to contact you with fundraising updates, events, and appeals.

Consent to be contacted by our Fundraising Department(Required)

Fundraising Events

Appeals

Fundraising Newsletters

All of the above

None of the above

For a two-day assessment with 6 months of keyworking, the total cost is £2790.73. Families contribute £990, and we need to raise the remaining £1800.73 to cover the full cost, including the therapeutic plan and ongoing support for families.

Sharing Your Experience

At bibic, we may share anonymous stories of families who have worked with us to help others understand the support we offer. Your experiences can help reach more families in need.

Permission to use your bibic journey in an anonymous case study for our Trustees' report and other fundraising materials:(Required)

Yes – I consent to sharing my journey in an anonymous case study

No – I do not consent to sharing my journey

Would you be happy to share anonymously your bibic experience publicly (for example, on our website, within appeals or in our promotional materials)?(Required)

Yes – I am happy to share my experience

No – I do not wish to share my experience

Participation in Future Surveys

Your responses help us improve our services.

Would you be happy to participate in any future surveys?(Required)

Yes – I am happy to participate in future surveys

No – I do not wish to participate in future surveys

Declaration and Signature

Signature(Required)

I confirm that, I have provided accurate contact details. I understand how my data will be used and how I can change my preferences at any time, I understand that consent is voluntary and will not affect the services received.

Signature date(Required)

Read bibic’s Privacy Policy