buckinghamshire

Online registration is only available if you are 16-24 and live in Buckinghamshire.

If you are under 16, you can register for a c-card by visiting your nearest outlet that provides the registration service. Click here to find an outlet near you.

If you are 16 or over, you have the option to register online, by filling out the form below, or at an outlet (see link above).

Please refer to our privacy policy to review how we manage your data

 

 

about you

Please complete all the required fields below. Any blue fields are optional.

Outlet Code
Initial  & Surname
 
Date Of Birth
/ /
Gender
Ethnic Background
Sexual Orientation
Postcode

Please enter Postcode and click 'Lookup'.

Why we ask for your postcode? (show)

How did you hear about the Scheme?

Mobile Number
Email Address
Confirm Email Address
Condom Demonstration
Please tick to confirm you have watched the Condom Demonstration.
Data Protection

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Resident of Borough *