Name

Job title

Phone number

Email address

Your interest in becoming a member of Forum

Individual Data Protection Statement
With your permission, the information you have provided will be stored and used for the following purposes:

For the distribution of newsletters, briefing papers, consultations, events, news and other information by Forum CIO teams and partner/member organisations, to yourself. This includes invitations to the Annual General Meeting or any Extraordinary General Meetings.

Consent

I am happy to receive the monthly bulletin from Forum CIO and notice of any Annual General Meetings or Extraordinary General Meetings
yesno

Data protection release:

I understand that the information I have provided will be used only for the purposes specified on the form, and will be stored in accordance with the provisions of the Data Protection Act (1998)
I understand

Section One - Your Organisation

Organisation type
Registered charityCommunity groupCommunity Interest CompanyCompany Ltd by GuaranteeStatutory body e.g. School or CouncilOther (please specify)

Organisation Name

Charity and/or company number if applicable

Name of main contact

Position of main contact

Address of organisation

If this is a private address that cannot be listed on our website, please tell us here

Postcode

Telephone No.

Email Address

Web Address

Twitter

Main activities

 
 

Section Two - Your Activities Main area(s) of work (please select no more than ten categories)
AccommodationAdvice/information servicesAdvocacyAnimal welfareArts and HeritageBefriendingCampaigningCarers services/home supportCommunity developmentCommunity services/facilitiesCounselling/therapyCrime/community safetyDay care servicesDomestic/sexual abuseEducation/trainingEmployment supportEnd of life careEnvironment/conservationFaith/religionFamily servicesGrant givingHealthHomelessnessLunch clubsHousing/related supportInternational aidMediationMental Health servicesMentoringOut of school provision/play workPoverty/low incomeRegenerationSexual healthSocial activitiesSocial and Community careSports & leisureSubstance misuseTelephone helplineTenants & residents servicesTranslating/interpretingSupport for CarersTransportVoluntary sector supportVolunteeringYouth workOther (please specify)
 
 
Section Three - Who do you work with or support? (Please select all that apply)
Whole community e.g. in an areaBlack, Asian and Minority Ethnic groupsCarers ChildrenDementia (people with)Disabled people (all)Faith groupsFamilies/ParentsLGBTQ+Gypsies and TravellersHomeless peopleLearning disabilities (people with)Long term/chronic illness (people with)Mental health problems (people with)Lone parents Low incomeMen onlyMigrant workersOffenders/ex-offendersOlder peoplePhysical/sensory impairment (people with)Refugees/asylum seekersTenant and residentsSubstance misusersSurvivors of AbuseAcquired Brain injury (people with)UnemployedVictims of crimeVoluntary & community groups or social businessesVolunteers Women onlyYoung peopleOther (please specify)
 
 
Section Four - Where does your organisation work or provide services?) (Please select all that apply)
CalderdaleEast Riding of YorkshireHull (all)Hull – EastHull – WestHull - NorthNorth East LincolnshireNorth YorkshireWest Yorkshire YorkYorkshire and the HumberHumber sub-regionOther (please specify)
 
 
Section Five - Your Data Protection
 
With your permission, the information you have provided will be stored and used for the following purposes:
 
1.For the distribution of newsletters, briefing papers, consultations, events, news and other information by Forum CIO teams and partner/member organisations, to yourself. This includes invitations to the Annual General Meeting or any Extraordinary General Meetings.
2.For inclusion in the Hull City Council community database and website
3.To support the work of the Hull Social Prescribing Teams, allowing referrals to your organisation as appropriate
4.The contact and activity information provided will be made available to the public. This will include an entry on the Forum website and online maps. This will help to promote your organisation, its work and activities.
 
Please note that

1.The data contained in these databases will not be passed on as a mailing list to other agencies.
2.The data contained in these databases will not be used for marketing or fundraising, beyond the activities outlined above
3.However, your contact details (organisation, address and phone number/e-mail) may be passed to individuals, partners and member organisations where relevant (e.g. when an individual or member organisation requires access to your services)
4.By ticking the boxes below, you can opt in to each of the purposes outlined above. However, you can opt out at any time by e-mailing [email protected] or ringing 07791 040433 and asking for Pippa Robson
 
Consent

I am happy to receive the monthly bulletin from Forum CIO and notice of any Annual General Meetings or Extraordinary General Meetings
yesno
 
I am happy for my information to be included in Hull City Council’s community services database and website if applicable
yesno
 
I am happy for my information to be shared with the Hull Social Prescribing teams
yesno
 
I am happy for the information to be publicly available on the Forum websites under Membership
yesno
 
Data protection release:

I understand that the information I have provided will be used only for the purposes specified on the form, and will be stored in accordance with the provisions of the Data Protection Act (1998)
I understand