Member Information Form

Name of University, College, Company etc. (if applicable)

Name & Email address of person in charge of NADP Membership*

Please provide the name & email address of the designated person at your Institution in charge of NADP Membership who has consented to adding you on.

Name*

Prefix First Last

Like to be known as...

Phone

Email address for communication from the NADP office*

For communication from the NADP Office and registration on the website and JISCMail lists, if required

Job Title

Any additional information (e.g. Communication preferences)

I wish to be registered on the NADP website so that I can access subscriber-only resources (conference slides, members’ resources etc.)*

Yes
No

I wish to take out a free subscription to the NADP email based internal discussion groups (JISCMail)*

Yes
No

I am the Head of a Disability Service and I wish to take out the one free subscription to the NADP Heads of Service list*

Yes
No

The Heads of Service list is for one person per educational membership

NADP Equality & Diversity Monitoring Form

We like to know a little about the backgrounds of our members and associates in order to describe NADP according to the protected characteristics identified in the Equality Act (2010). You do not need to complete this section but it does help us monitor our member characteristics. If you decide to share information with us it will be be retained confidentially in accordance with our privacy policy and used only for preparing anonymised reports.

Age: please tick the category which applies

18 - 25 years
26 - 35 years
36 - 45 years
46 - 55 years
56 - 65 years
66 - 75 years
76 years and over
Prefer not to say

Ethnicity: please tick the category which applies

Gender

Religion

Sexual Orientation: please tick the one which applies

Do you have an impairment, health condition or learning difference that has a substantial or long term impact on your ability to carry out day to day activities? (tick all that apply)

A specific learning difference (e.g. dyslexia)
Autistic Spectrum Condition
Blind/partially sighted/visually impaired
Deaf/hearing impaired
Medical Condition (e.g. diabetes/epilepsy/asthma/ME)
Mental Health Condition
Wheelchair user/mobility/ dexterity impairments
No known impairment, health condition or learning difference
Prefer not to say