JT_TEST_5729

Name of group or organisation (required)

Department (if you are signing up on behalf of a distinct part of an organisation)

Brief introduction to your organisation/service

I confirm that I have watched the films (please check all boxes):

SAND's Journey to EMBRACE A Culture of Inclusion
Gen Silent (Trailer)
70 Years through LGBT+ Eyes
Dignity Day

Covenant lead nominee

Name (required)

Position in group/organisation (required)

Email address (required)

Phone number (required)

Facilitator network member

Name (required)

Position in group/organisation (required)

Email address (required)

Phone number (required)

Public contact

Please give public contact details for queries/to report issues.

Email address (required)

Phone number (required)

Organisation address (required)

Website URL (required)

I confirm that the above group/organisation/department (please check all boxes):

Operates in Shropshire, Telford & Wrekin
Signs up to the 5 commitments of the EMBRACE Covenant

I confirm the organisation's 5 key actions are (please complete all fields):

Today's date (required)

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