Sharing Your Experience Consent Form

Surviving Economic Abuse produces a range of communications materials to help raise awareness of economic abuse. We like to share the experiences of women who have experienced economic abuse first-hand to demonstrate the significance of the issue and transform responses to it.

By completing this form, you give us permission to use your story in external and/or internal communications discussed with you, and to keep your story on file until you withdraw your consent. If an opportunity arises to share your story again as part of a new activity, we will always check with you first. For more information on how your data is stored, please read SEA’s full privacy notice.

Thank you for sharing your story to help us raise awareness of economic abuse.

Name(Required)

First Last

Preferred name

If you prefer to be called something different to the name you have listed above, please let us know here.

Preferred pseudonym

We will use a pseudonym (a name someone uses instead of their real name) to protect your identity. If you have a preferred pseudonym, please let us know. You should avoid picking a name that is similar to your own, or one that could make you identifiable. If you don’t have a preferred pseudonym, we can pick one for you.

Phone number(Required)

Email address(Required)

Region(Required)

Region (Other)(Required)

Please let us know your region if you selected “Other” from the list above.

Quote Reference(Required)

Please enter the Quote Reference number that will have been provided to you by a member of Team SEA. If you don’t have one, please contact [email protected]

Has there been a successful prosecution against the perpetrator?(Required)

Consent for processing sensitive prosecution data(Required)

Yes, I consent to SEA processing this data

You have indicated that there has been a prosecution related to your story. Sharing details about criminal convictions is considered ‘special category data’ under data protection law, which requires your explicit consent. By checking this box, you explicitly consent to us processing this information about criminal convictions solely for the purpose of determining anonymity needs for your story. Data protection law requires use to handle this data confidentiality and sensitively.

Please provide more information about the prosecution if applicable

Anonymisation of your story

At SEA, we are committed to protecting your privacy. By sharing your story, you help us raise awareness while we ensure that your privacy is safeguarded. Here’s how we handle the anonymisation of your story:

We remove anything that could directly identify you, like names and addresses, and change details to prevent your story from being traced back to you.
We check that there is no reasonable likelihood of re-identification, keeping your information secure.
Your pseudonymised data is still treated as personal data and handled strictly in accordance with data protection law.
Your story will only be shared with the party/channel we have discussed with you before filling out this form. If we have another opportunity to share your story, we will discuss this in advance with you and ensure we gain your consent to do so.
You can withdraw your consent at any time, which will stop us from using your anonymised story in new activity.

Please let us know if there are any particular identifying features you do NOT want included in our communications work, or any ways you do NOT wish to be represented or described

Consent to use your story(Required)

Yes, I consent to the agreed use of my story

By checking this box, you are agreeing you are happy to give permission for your story to be used by Surviving Economic Abuse for the agreed communications work. We will handle the details recorded in this form in accordance with our Membership Privacy Notice and data protection law.

Your General Data Protection Regulation (GDPR) rights

The information you provide here will only be used to contact you about sharing your story as set out above. We will not pass the details recorded on this form to any other organisation without your permission. You have specific rights under the General Data Protection Regulation (GDPR) to expect that your personal data will be protected:

Access: Request access to your data at any time.
Rectification: Correct incomplete or inaccurate data we hold about you.
Object: Object to the processing of your data under certain conditions.
Erasure: Ask to delete your data if it’s no longer necessary for us to keep it.
Withdraw: Withdraw your consent to use your data whenever you choose.

To exercise any rights, please contact our Data Protection Officer by emailing [email protected].

We are committed to respecting these rights and will address your requests promptly.

What will my story be used for?

By signing this consent form, you are giving permission for the information you have provided (referred to here as ‘your story’) to be used in an anonymised form in SEA’s external and internal output. Should the opportunity arise to share your story again in the Press or on SEA’s Communication Channels you will always be contacted about this first. Outputs could include (but are not limited to) any of the below:

SEA’s Policy and Campaign Work – reports to Government, consultation responses, roundtables.
SEA’s Fundraising Work – eg. grant applications, fundraising campaigns and reports for funders.
Press – national and regional television, radio, papers, magazines and news sites. (Please note that if you do decide to take part in any media interviews, we will be in touch to discuss your safety further)
SEA’s Communications Channels – social media, website, leaflets, newsletters and other marketing materials.
Training Materials – materials produced by SEA to train professionals and individuals (e.g., banks, police).

Your right to withdraw consent

You have the right to withdraw your consent at any time. However, please be aware that withdrawing consent does not affect any use of your data that has already occurred. For example, materials such as published stories or reports that include your data cannot be recalled or removed from circulation once they have been made public. We will stop all future use of your data once you withdraw consent and take all necessary steps to prevent its use in upcoming projects or publications.

How to withdraw consent: To withdraw your consent, please contact us directly by emailing us at [email protected]. Upon receiving your request, we will discuss the specific materials or circumstances under which you’d like to withdraw your consent and make appropriate updates to our records. This process ensures that your decision is respected and implemented effectively.

Consent to data storage(Required)

Yes, I consent to storage of my data

By checking this box, you consent to SEA storing your personal data for our own internal record keeping, and to contact you in case of future opportunities. We will keep your data for as long as necessary to fulfil the purpose for which it was collected. You can withdraw your consent at any time.