Sign up for our 2021 support programme
The following details will be used to send you instructions on how to join Bloom. Your details will be kept private and secure in accordance with our Privacy Policy which can be found on Your safety and privacy is what matters to us and we only ask for details that help us match programme content to your personal needs.
Your email address *
We need this so we can send you instructions for joining the Telegram and/or WhatsApp groups.
Which courses are you interested in? *
Which platform would you prefer? *
Either way, you won't be able to see the details of other participants and they won't see yours. On WhatsApp, Chayn admins will be able to see your number and you will need to add our number. On Telegram, we can't see your number and you can't see ours unless you share your details with us (you don't have to). Your privacy and safety are very important to us so choose the option that's the best for you.
Are you currently living with an abusive person(s)? *
Your country: Where you grew up or call home *
This helps us customise course content for you.
Your country: Where you live right now *
This helps us customise course content for you.
Your privacy
Your privacy is of the utmost importance. Bloom has been designed to be as safe and confidential as possible.

This is what we collect from you: 1) Information provided in the sign-up form, including e-mail address, 2) Phone number (to be requested later); 3) Information in the sign-up survey completed after course has started, as well as our weekly evaluation form (which is anonymous); 4) Any chat transcripts form our 1-to-1 conversations.

Google analytics are also used on the Bloom website to catch trends of where and when people visit our site.

How we use this information: Your email address is needed for us to contact you about the course. Your number is needed for us to add you to a WhatsApp group, as there is no other way to get in touch. If you choose to receive our messages via Telegram, we don’t need your number and will simply e-mail the link to join. In Telegram, you won’t be able to see our number and we can’t see yours. In WhatsApp, your number will be hidden from the rest of the group.

We use the chat transcripts and evaluation forms to analyse effectiveness, inform and adapt course content, and to improve our service.

When we delete your information: Your chat transcript will be deleted within 6 months of the course end. Your e-mail address and phone number will also be deleted from our spreadsheets and database. Other information, such as the courses you signed up for, will remain so we can keep count of member numbers and the work we have supported.

If you signed up for our newsletter, your e-mail address will be saved in our newsletter list.

IMPORTANT: We will never publish anything you've said without express consent. We may use a paraphrased summary of what you've told us as general feedback on social media or to promote the work we do, but we will never directly identify you or expose personal information (in any medium) that would put you at risk or reveal intimate or identifying details.

Chayn's full privacy policy is available here:
Do you understand and agree to our Privacy Policy? *
Would you like us to email reminders for upcoming courses, events, and Chayn news? By saying yes, you'll be added to our infrequent newsletter.
Clear selection
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy