My date of birth My full address and postcode My email address My phone number My signature Today’s date I have included a picture of myself (delete as appropriate): Yes If you are under 16, we also need your mum, dad or legal guardian’s permission to store and share your story and photograph. Mum, dad or legal guardian’s name Their email address Their phone number Their signature Today’s date My story Please tell us your story in your own words. Around 100 words per box should be plenty! But you can write more or less if you like. This is what my life was like before I became ill with M.E.: This is what my life is like now:
My date of birth My full address and postcode My email address My phone number My signature Today’s date I have included a picture of myself (delete as appropriate): Yes If you are under 16, we also need your mum, dad or legal guardian’s permission to store and share your story and photograph. Mum, dad or legal guardian’s name Their email address Their phone number Their signature Today’s date My story Please tell us your story in your own words. Around 100 words per box should be plenty! But you can write more or less if you like. This is what my life was like before I became ill with M.E.: This is what my life is like now:
this-is-me-story-form-2018.docx