Please circle yes or no as applicable and sign and …

Dear Applicant, Glasspool Charity Trust is a grant making charity that provides small grants to individuals and families. To enable your support worker to make an application to us on your behalf, seek additional grant support from other charities, and for our suppliers to deliver an item to you, we need to obtain your consent as to which organisations we may share your personal and sensitive personal data with. Personal data is information about you such as your name, postal address/email address and phone/mobile number. Sensitive personal data is a type of personal data such as: ethnicity/racial origin and physical/mental health or disability. We are a data controller registered with the data protection regulator, the Information Commissioner's Office (ICO). Please circle yes or no as applicable and sign and date below where indicated. I confirm that I have read Glasspool Charity Trust's privacy policy provided Yes No with this form I freely give my fully informed consent for the following organisations to use my personal and sensitive personal data as outlined in the privacy policy.

Version 1.3 07/06/18 Dear Applicant, Glasspool Charity Trust is a grant making charity that provides small grants to individuals and families.

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