FREE RECYCLED SMART DEVICE

Apply for a smart device

Name
Address

Equality and Diversity

Aishah Help wants to meet the aims and commitments regarding equality and diversity for our volunteers. This includes not discriminating under the Equality Act 2010, and building an accurate picture of the make-up of the volunteers in encouraging equality and diversity. The organisation needs your help and co-operation to enable it to do this:
Proof of identity
I hereby consent to Aishah Help using images of myself caught in video recordings, and/or photographs, taken/recorded (we will not show face if requested).
i have a smartphone
i have access to the internet
Would you appreciate follow-up support or training after receiving the smart device?
Do you have someone who can help you set up and use the smart device?
Do you have any visual or hearing impairments that we should be aware of?
I confirm that the information I have supplied is true and correct to the best of my knowledge. I understand that any false or undisclosed information could result in the closure of my application for assistance.