The Breast Cancer Care Show
Model application form 2017
1. ABOUT YOU
Name:
Address:
Postcode:
Email:
Home tel no:
Mobile tel no:
Do you use Facebook, twitter or have a blog? Yes *No
*If yes, then please provide your blog address and/or your twitter handle here:
Date of birth: / /Dress size:
Marital status: Hair colour:
Current occupation and employer: Shoe size:
Childrenand age: Bra size:
Height: feet inches
Travel time from your home to London Waterloo train station:
Please select your ethnicity:
A. White
English/Welsh/Scottish/Northern Irish/British
Irish
Gypsy or Irish traveller
Any other White background, please state:
B. Mixed/multiple ethnic groups
White and black Caribbean
White and black African
White and Asian
Any other mixed/multiple ethnic background, please state:
C. Asian/Asian British
Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background, please state:
D. Black/African/Caribbean/black British
African
Caribbean
Any other Black/African/Caribbean background, please state:
E. Other ethnic group
Arab
Any other ethnic group, please state:
2. YOUR MAILING PREFERENCES
We’d love to keep you up-to-date with our news, activities and other ways you can get involved, including supporting our work.We never sell or swap people’s details with third parties and you can change what you receive from us at any time.
I’m happy to receive such information by email
I don’t want to receive such information by post
3. YOUR EXPERIENCE OF BREAST CANCER CARE
Are you currently registered as a Breast Cancer Care volunteer? Yes No
If yes, how long have you been a volunteer and what are your main activities?
Have you ever taken part in any other Breast Cancer Care fundraising activities and if so please let us know what you did?
How did you hear about The Show?
Have you applied to be a model in The Show before? (If yes, how many times):
Have you used any of Breast Cancer Care’s services in the past? Please specify which services you have used and how have they helped you?
4. YOUR EXPERIENCE OF BREAST CANCER
When were you diagnosed with breast cancer and how old were you?
In 500 words or less please tell us as much as you can about your experience of having breast cancer including your diagnosis, treatment and timings:
In 250 words or less please tell us how having breast cancer affected your life and/or changed you as a person (such as family, children, relationships, job, lifestyle, body image)?
In 250 words or less please state what advice you would give to someone whohas been diagnosed with breast cancer:
In 250 words or less please state why would you like to be a model in the Breast Cancer Care Show:
5. TICKET SALES
The Show is a fundraising event and we ask all models to help us promote tickets for The Show to ensure we can raise more funds to support people affected by breast cancer.
Would you be happy to promote ticket sales and how would you do this (2016 ticket costs were £75 for the afternoon and £195 for the evening)?
6. KEY DATES
If successful you will be asked to attend a welcome day in London which is currently scheduled for Thursday 27 April 2017and model fitting day which isWednesday 20September 2017.Please keep both of these days free if you are selected.
Can you commit to attending both dates? Yes No
Breast Cancer Care are unable to organise travel for all models to attend the information day, fitting day and The Show.However, we do not want this to stop you applying so if you would like help covering the costs and organising your train travel then please tick this box
Please note that this won’t affect your application.
The 2017 Show is booked to take place on Thursday 28September 2017 at the Park Plaza Westminster Bridge hotel in London. This date may be subject to change. Please keep your availability during this period in mind when making your application to The Show 2017.
7. MEDIA
Following selection into the final group, the press and communications team at Breast Cancer Care mayask you to take part in media work that exists around The Show and October, Breast Cancer Awareness Month. We ask you to tick the box here to confirm that if you are chosen to model you would be willing to take part in media work (please tick).
If successfully chosen, I agree that during my time as a model not to take part in other media or campaign activities related to other breast cancer charities
Please tick here if you would be willing to take part in media work for Breast Cancer Care even if you are not chosen to model (please tick).
Please send in a recent picture of yourself with this application form.
Please return this form with attached pictureby 5Marchto:
If you have any queries please call the Events team on 0345 092 0806.
Many thanks and good luck!
First round selection will take place in March, when all applicants will be contacted.