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Emergency Contact and Medical Form Onboarding Form - Techscaler Japan - 2026

Please complete this form by 12 noon, Monday, 2 March (UK time). Your answers to this form can only be accessed by the following CodeBase Team Members, to ensure the delivery of the programme:
- Ruth Oliver, VP Strategic Partnerships / Client Accounts
- Anaïs Guillemaud, Head of Scaleup Acceleration Programmes
- Sally Dale, Programme Manager
- Nawal Abusultan, Programme Coordinator
- Jessica McClure, Programme Coordinator
- Debbie Baird, IT Manager
- Accompanying Programme Manager(s)
The information you provide is collected by Techscaler via Tally and stored securely within our private Google Drive. In compliance with UK/EU GDPR and Japan’s APPI, your data is processed solely for the administration of the Techscaler Japan Programme. All personal and medical data will be permanently deleted by 31 October 2026, following the completion of the Techscaler Japan Programme.

Your full name

Your email address

Your phone number.

Do you have any medical and/or accessibility information you'd like us to know?

Your emergency contact's name

Your emergency contact's relationship to you

Your emergency contact's phone number.

Is there anything else we should know about your emergency contact?

Would you like us to add you to you to a cohort Whatsapp group?

Please note that:
- Only phone numbers will be shared with Whatsapp/Meta for the purposes of communication - If you join, your phone number will be visible to other members of the group - All group chat participants are expected to abide by our Code of Conduct
- That the group will not be managed or regularly supervised by Team Techscaler. Please continue to contact our team via email.
Would you like us to add you to you to a cohort Whatsapp group?
A
B
C