Share your story

Please fill in this form if you want to share your story with us. We may use your story on website, your local press and our social media channels to raise awareness. The questions are simply a guide; please feel free to add any additional information

Troy

Please email our team if you have any queries.

Share your story

Personal details

Title

First Name

Last Name

Phone

Whichever is your preferred number

Reason for contacting us

Address

Street address

Town

County

Postcode

Photos and Consent

If you have a photograph you would like to share, to help us use your story in the press, on social medial or on our website please upload it below and complete the permissions below.

Please upload a photo here

Meningitis Now uses photographs and video film for publicity purposes. These images may appear in our printed publications, on our website, or both. We may also send them to the news media. We require your permission to do this.

May we use your images:

	Yes	No
In printed publicity or promotional literature produced by Meningitis Now, including leaflets, posters, newsletters and other display materials?
On Meningitis Now's website and other social media sites, including, but not limited to, Facebook, Twitter and YouTube?
In publicity material about our services, to the news media, especially the local press?

Keep in touch

Please let us know what you'd like to hear about

Get informed: Meningitis informationGet support: How we support those affected by meningitisGet involved: How you can support usAll the aboveI don't want to hear from youMeningitis Information:- includes updates about the impact of the disease, vaccine programmes, our campaigns, and media activity...... How we support those affected:- includes our Family Days, Believe & Achieve weekends, Forever Days, invitations to some key events organised by us e.g. Christmas Carol Concerts...... How you can support us:- includes information about donating your time through volunteering or organising fundraising activities, how to get involved by taking part in an event such as Three Peaks Challenge, or our Five Valleys Walk and how you can donate to us through our cash appeals, or by purchasing merchandise e.g. Christmas cards

And please let us know how we can contact you

EmailPostTelephoneSMS

We will only communicate with you about the aspect(s) of our work you’ve requested, in the way(s) that you have requested. We may also contact you for administrative purposes or to fulfil a service or request. We never sell our supporter data and only share this with suppliers helping us in our cause. To find out more about how we process personal data and respect your rights, please visit our privacy policy.

Need assistance with this form?

I have not received any support	Helpline
Counselling	Complimentary therapy
Home visit	Family Day
Believe & Achieve weekend	Creative therapies
Financial Support Grant	Volunteering
Fundraising	Website
Social Media	Other