Make a Difference Challenge

Please fill out this form and pay the annual programme fee to be given access to the Make a Difference Challenge platform and materials. If you have any problems completing this form please contact: info@youngcitizens.org

School/Organisation Details

School or Organisation Name

School or Organisation Postcode

Please include a space in your postcode e.g. YC1 2CY

How did you hear about the programme?

Lead Educator Details (This is the person we will use as your key contact.)

First Name

Last Name

Job Title

Personal Work Email Address

This is the email that will be linked to your main account. Please give your personal work email address. The email must be for the named individual, not office@, info@ or admin@

Your annual licence allows up to 3 teachers per organisation to access the training and resources package. If you know the name of the additional teacher who will use the resources alongside you please fill out the section below

Tick the box below to add a second teacher

Are you part of the senior leadership team?

Additional Educator Details (This is any colleague who will also undertake the training.)

First Name

Last Name

Job Title

Personal Work Email Address

This is the email that will be linked to your main account. Please give your personal work email address. The email must be for the named individual, not office@, info@ or admin@

Are they part of the senior leadership team

Supporting Senior Leader

A school or college application must have the approval of the senior leader (head teacher/assistant principal etc), who can help support the level of commitment needed for this programme and should help accommodating the preparation for the programme (i.e. timetable flexibility).

First Name

Last Name

Job Title

Personal Work Email Address

This is the email that will be linked to your main account. Please give your personal work email address. The email must be for the named individual, not office@, info@ or admin@

Payment

You will be charged:

Annual Fee:

Name on Card

Code

Card Number

Billing Email

Yes, I would like news and updates about free lessons, resources and programmes from Young Citizens via email.

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