PPDI_contact

Public Policy Development & Implementation Programme

Participant Information & Emergency Contact Form

Dear Participants,

To help us ensure the safety, wellbeing, and effective support of all participants throughout the programme, please complete this form. The information provided will be treated confidentially and will only be accessed by authorized programme staff when required for programme administration, participant welfare, or emergency situations.

Please complete all mandatory fields and notify the programme team if any information changes before or during the programme.

Section 1: Participant Information

Full Name:

Passport Number:

Section 2: Emergency Contact Information

Please provide the details of a person who can be contacted in the event of an emergency.

Primary Emergency Contact:

Primary Full Name:

Relationship to Participant:

Mobile Number:

Secondary Emergency Contact: (Optional)

Secondary Full Name:

Relationship to Participant:

Mobile Number:

Section 3: Medical and Wellbeing Information

The information in this section will only be used if required to support your health, safety, or wellbeing during the programme.

Do you have any medical condition that programme staff should be aware of in the event of an emergency?

Yes

Please provide details:

Do you have any allergies (e.g., food, medication, environmental)?

Yes

Please provide details:

Do you carry any emergency medication (e.g., inhaler, EpiPen)?

Yes

Please provide details:

Do you have any accessibility, mobility, dietary, or other support requirements that we should be aware of?

Yes

Please provide details:

Section 4: Travel Information

Arrival Date:

Departure Date:

Section 5: Additional Information

Is there any additional information you would like the programme team to be aware of?