Share your story form - Cyfannol Women's Aid

Thank you for deciding to share your story with us.

It will take just a few moments to complete our form. We’ll keep your details nice and safe and contact you when there’s an opportunity to share your story.

We understand sharing your story or talking about your past might be overwhelming so please note that you won’t be able to save and come back. If you’d like to take your time to tell your story, please write your it elsewhere (e.g. in Microsoft Word) and copy/paste into the form later on.

Ready?

Your Details

Title

First name

Last name

Email Address

Telephone No

Please tell us which age range you belong to. We ask this to help us represent all age groups

Which area of the Gwent are you in?
We ask this to help us represent all areas of the Gwent.

Your Consent

The information you've given us on this form will be used by Cyfannol Women’s Aid to contact you about your story.

We will never use your story or details with any other organisation or third party without your permission.

You can withdraw your consent to be contacted by us about your story at any time by emailing fundraising@cyfannol.org.uk. Information about how we protect and use your personal data is set out in our privacy policy at cyfannol.org.uk/privacy

Where would you be happy for your information to be used? Tick boxes select one or more
Internal training & communications purposesExternal reports to funders and other agenciesExternally for fundraising campaignsExternally for, social media, other media sources including Cyfannol’s newsletter.

How would you like your story to be presented?
First NameMade-up First NameAnonymous

Your Story

Could you tell us what your story is related to?

Tell us briefly about your story and why you want to share your story

Keep in Touch

We will get in touch from time to time to check you’re happy with how we are using your story. We take your privacy seriously and will never sell or swap your details with third parties. Information about how we protect and use your personal data is set out in our privacy policy at cyfannol.org.uk/privacy