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Thanks for your interest in the Eye Want Change Youth Jury programme! 

Please be aware that applicants must be between the ages of 15 and 21. The form may also be downloaded HERE and emailed to eyewantchange@gmail.com. The deadline for applications is midday 12:00 GMT on Friday 3 February 2017.

Name *
Name
Please tick to confirm you can attend a meeting in Central London (location TBC) on this date: *