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Carer Application Form

This year's Carers Parliament will be held on 6 October 2015 at Murrayfield Stadium, Edinburgh

The provisional theme for this year's Carers Parliament is "Addressing the issues: carers shaping the future"

If you complete this form you will be entered into the ballot for places. This ballot is carried out by carers on the Steering Group (which is organising the event).

The ballot will be carried out based on parliamentary constituency to ensure that carers from across Scotland are represented.

The draw will be held in late July and we will inform you of the outcome in early August. There will be two delegates selected from each of the 73 Scottish parliamentary constituencies.

Closing date for applications for the ballot is MONDAY 27th JULY 2015
The Carers Parliament ballot is open to all unpaid carers and former carers. Kinship carers can also apply if they are caring for a child with a disability.

A small number of additional places have been reserved for carers who are contributing to the programme, for example as members of the steering group or speakers for the workshops and to ensure minority groups and young carers are represented.

Funding is available to support carers to attend. This will include travel and subsistence and, if required, accommodation and replacement care costs.
A small number of additional places have been reserved for carers who are contributing to the programme, for example as members of the steering group or speakers for the workshops and to ensure minority groups and young carers are represented.

Funding is available to support carers to attend. This will include travel and subsistence and, if required, accommodation and replacement care costs.

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* First name

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* Surname

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* Your address:

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* Telephone or mobile number

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* Email address:

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* Scottish Parliamentary Constituency
(Please choose from the list below. If not known, please leave blank and we will complete for you)

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* How did you find out about the Carers Parliament?

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* The data we collect in the form will be used solely for the purposes of the Carers Parliament including, if you are successful, to register you as a delegate, and for all applicants, to share a final report.

Otherwise your details will not be shared without your consent. However, we would like to keep you up to date with other developments, events for carers and information.

  Yes No
Can we share your information with the other national carer organisations in relation to other RELEVANT events?
Can we contact you in future about other issues related to caring e.g. events, information or new materials?
Can we share your details with your local MSP?
Thank you for completing this application. The closing date for applications is 20 July 2015. If you are successful in the ballot to select delegates, we will contact you in early August.
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