What is your first name and age?

Your email address (we will use this to keep you up to date with The Midlife Movement, including the (B)OLDER Project)

How do you feel you are growing (B)OLDER?
Would you be happy to be interviewed by Jo and appear on video?

I understand that by taking part in this project, I give permission to Jo Blackwell and The Midlife Movement to use my story, my image, full name and age in a video and/or podcast and/or print, and across social media without time limit as part of the (B)OLDER Project.
I will not receive any remuneration for this usage and I also understand that my contribution might NOT be used.

Please upload a high resolution (at least 1mb) photo of yourself to be used to promote your appearance.