Epilepsy Action Research Network

Application Form

I would like to become a member of Epilepsy Action Research Network

Name and Address

Title:

First name:

Surname:

Address:

Postcode:

Home telephone:

Mobile telephone:

Email:

About you

Are you a member of Epilepsy Action:

Yes

Which of the following best describes you?:

I have epilepsy myself

I am a carer for a friend or family member with epilepsy

A family member has epilepsy

Please tell us how old you are:

Which ethnic group do you fell you belong to?:

All applications for Epilepsy Action research funding are submitted electronically. It id quicker and more efficient if we are able to email you the applications rather than posting them.

How would you prefer us to contact you?:

If you would prefer to receive the printed versions of applications, do you have any special requirements?:

Please give us a little background information about yourself and tell us why you would like to be an EARN member:

Declaration: *

Please select

In accordance with the Data Protection Act 1998, I give consent for the information in this form to be processed, in accordance with Epilepsy Action's policy, for the purposes of recruitment and voluntart work

Date:

Epilepsy Action privacy policy

Epilepsy Helpline

UK freephone 0808 800 5050
International +44 113 210 8850
Email: helpline@epilepsy.org.uk
Txt msg: 07797 805 390 info

Epilepsy Action blog

Government consultation on the future of care needs in England

The UK government is consulting on the future of the care and support needs in England.

Epilepsy on BBC Radio 4’s Woman’s Hour today

Advances in treatment for children with epilepsy were discussed on BBC Radio 4’s Woman’s Hour programme this morning.

Ask your MP to meet with a health minister

Last summer, you may remember that the report Wasted money, wasted lives was published. It looked at the human and economic costs of epilepsy in England, and condemned the continued government failure to meet the needs of people living with the condition.