You can also download a PDF of the membership form HERE.


Young Person's Membership Form

To be filled in by young person.

Please tell us a bit about you.

Please type in the format 07888888888 or 02030111333.
Date of Birth *
Where did you hear about Spotlight?
Gender *
What are your interests? *
Are you in education or training? *
Do you consider yourself to have a disability? *
What kind of disability? *
What is your ethnic group? *


Parent/guardian details


I give permission for Spotlight to collect and securely store and use information, photos and film footage of me and use it to promote Spotlight and its partners work *
I understand that information may be shared with partner organisations to support me and the services I access *
I agree to Spotlight communicating with me by email, phone, text and post
I confirm that all the information provided in my membership form is true and correct *

If you do not want photos or videos of you to be shared on social media, website or on materials to promote Spotlight please email

Spotlight and Poplar HARCA is committed to protecting your personal information. The information collected above will be used to provide services to you. We will never pass your sensitive personal data onto a third party, unless we have obtained your consent or when legally required to do so. All information collected will be stored on our internal database for monitoring and service provision purposes. By submitting this form, you are agreeing to Poplar HARCA using your information as outlined here.

View our privacy notice HERE.