Coastal Community Leaders 2024 Application Form
Please complete the form below and click 'Submit' to apply to the program. All responses will be kept in full confidentiality. We will aim to respond to you within 48hrs. Any questions, contact
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Email *
Full Name *
Date of birth
Contact phone number:
Gender *
Ethnicity (optional): *
Which area of Holyhead or its surroundings do you live in?
What is your current education, care or work status? 
Have you participated in any environmental programmes or initiatives before?
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What days are you available to attend the workshops?
Please indicate any skills or experiences you think are relevant to the programme (300 words max)
What do you hope to achieve by the end of the programme?   (300 words max)
Do you have any dietary restrictions?
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Do you require any special accommodations or support to participate in the programme? If yes, please specify.
The project team will conduct the program in English. We can provide translation services if you require them. Please indicate your language preference below.
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How did you hear about the program?
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Press submit to you send your application. A confirmation email will be sent to you upon submission.
A copy of your responses will be emailed to the address you provided.
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