NHS Kids Screening Recruitment

Hello all!

NHS Kids is a local community health screening project which aims to identify children and families in need of medical, social and educational intervention. Together with our partners, we act as a bridge for reconnecting these families with the services they require, to ensure that each child's needs are met regardless of their unique backgrounds.

Q1. Name
Q2. Matriculation Number
Q3. School & Faculty Q3. School & Faculty
Q4. Year of Study (as of Jan 2018) Q4. Year of Study (as of Jan 2018)
Q5. Contact Number
Q6. Personal Email Address
Q7. School Email Address
Q8. Languages spoken (please select all that apply) Q8. Languages spoken (please select all that apply)
Q9. Screening will be held on 30 June (Saturday) and 1 July (Sunday), from 10am-5pm. Please select the date you would wish to volunteer for. Q9. Screening will be held on 30 June (Saturday) and 1 July (Sunday), from 10am-5pm. Please select the date you would wish to volunteer for.
Q10. There will also be a compulsory Volunteer Training held on 5th June and 9th June at NUS to equip and prepare you for the screening.Please select the appropriate time slot. If you are unable to make the assigned time slot, please indicate it below, and which time slot you are able to attend :-) Q10. There will also be a compulsory Volunteer Training held on 5th June and 9th June at NUS to equip and prepare you for the screening.
Please select the appropriate time slot. If you are unable to make the assigned time slot, please indicate it below, and which time slot you are able to attend :-)
Q11. If you own an iPhone/iPad, please type in your Apple ID! Q11. If you own an iPhone/iPad, please type in your Apple ID!
Q12. Name of Next-of-Kin
Q13. Relationship with Next-of-Kin
Q14. Next-of-Kin's Contact Number

Compliance to Personal Data Protection Act (PDPA)

By filling this form, you agree to participate in this survey. Please direct all enquiries to NHS Kids at "yllsom.nhskids@gmail.com"  By indicating your consent to provide your personal data in this form, you agree to receive publicity materials, updates and important announcements by email and phone. I hereby declare all information I have provided as accurate, and understand that my information may be passed to relevant committee members for the purposes of contacting me and event organisation. All personal information will be kept confidential and used for the purpose(s) stated. I hereby give my consent to the survey-taker to collect my personal information for disseminating more information about this event and, from time to time, be called, sent SMS-es, text messages or emails on more details pertaining to, or related to, this event.Should you wish to withdraw your consent for us to contact you for the purposes stated above, please notify us in writing to Natalie Chan (88090551, natalie.chan@u.nus.edu), Haidah Kamal (91877174, e0057003@u.nus.edu) or Lee Qing Hui (81575676). We will then remove your personal information from our database. Please allow at least 7 business days for your withdrawal of consent to take effect. Should you have any other queries, please contact the above.Do you agree to provide your personal information for the above stated purposes?
By filling this form, you agree to participate in this survey. 

Please direct all enquiries to NHS Kids at "yllsom.nhskids@gmail.com"
 
By indicating your consent to provide your personal data in this form, you agree to receive publicity materials, updates and important announcements by email and phone. 

I hereby declare all information I have provided as accurate, and understand that my information may be passed to relevant committee members for the purposes of contacting me and event organisation. All personal information will be kept confidential and used for the purpose(s) stated. 

I hereby give my consent to the survey-taker to collect my personal information for disseminating more information about this event and, from time to time, be called, sent SMS-es, text messages or emails on more details pertaining to, or related to, this event.

Should you wish to withdraw your consent for us to contact you for the purposes stated above, please notify us in writing to Natalie Chan (88090551, natalie.chan@u.nus.edu), Haidah Kamal (91877174, e0057003@u.nus.edu) or Lee Qing Hui (81575676). We will then remove your personal information from our database. Please allow at least 7 business days for your withdrawal of consent to take effect. Should you have any other queries, please contact the above.

Do you agree to provide your personal information for the above stated purposes?
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