Join us

To become a member and receive our e-updates, please fill in the form below or download the form as a Word document and return it to the office: 1st Floor, Friends Meeting House, Clare Road, Halifax, HX1 2HX. Alternatively, email it to sectorsupport@nbforum.org.uk.

Section 1 – Your Organisation

Organisation Name
Main Contact
First Name
Last Name
Position
Address
Post Code
Telephone No
Fax
Email
Web Address
Twitter
Main Activities (A short description)

Section 2 – Your Activities
Main area(s) of work (please tick no more than FIVE options)

 Accommodation Advice/information services Advocacy Animal welfare Arts & Media Befriending Business support Campaigning Carers services Community development Community services/facilities Counselling/therapy Crime/community safety Day care services Domestic/sexual abuse Education/training Employment Environment/conservation Faith/religion Family services Financial services/advice Fund raising Grant giving Health Homelessness Lunch clubs Housing/related support International aid Mediation Mental Health services Mentoring Out of school provision/play work Poverty/low income Regeneration Sexual health Social activities Social and Community care Sports & leisure Substance misuse Telephone helpline Tenants & residents services Translating/interpreting Transport Voluntary sector support Volunteering Youth work Other (please specify)


Section 3 – Your Client groups

Please tick up to 6 MAIN groups, also put your main client group in the 'other' section.

 BME groups (all) Carers Children (0-14) Disabled people (all) Faith groups Families/Parents LGBT Gypsies and travellers Homeless people Learning disabilities (people with) Long term/chronic illness (people with) Mental health problems (people with) Lone parents Low income Men only Migrant workers Offenders/ex-offenders older people Physical/sensory impairment (people with) Refugees/asylum seekers Social entrepreneurs Substance misusers Survivors of Abuse Tenant and residents Unemployed Victims of crime Voluntary & community groups Volunteers Women only Young people (14-19) Other (please specify) and/or main client group


Section 4 – Where does your organisation work or provide services?

 Calderdale North Yorkshire East Riding of Yorkshire York Hull Humber sub-region North East Lincolnshire Yorkshire and the Humber Other (please specify)


Section 5 - Information and Publications

Please tick the following options:


Section 6 - Organisational information:

Organisation type and structure. Please tick all that apply:

Company limited by guarantee
Please give company number
Registered charity
Please give charity number

 Branch of a national voluntary organisation Local voluntary organisation Community development agency Private enterprise Community forum Self help/user led Community group or club Social enterprise or CIC Educational establishment Statutory – health sector Faith based group Statutory – local government Local Infrastructure organisation (LIO) Statutory – public sector Other (please specify)


Section 7 – Data Protection

  1. The Data provided on this form will be stored in the Sector Support Calderdale and North Bank Forum databases. It will be used chiefly for the distribution of newsletters, briefing papers, consultations and notification of events, news and other information by the NBF teams and partner organisations to yourself.
  2. The data contained in these databases will not be passed on as a mailing list to other agencies.
  3. The data contained in these databases will not be used for marketing or fundraising, beyond the activities outlined above at (1)
  4. 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)
  5. Additionally, with your consent, the information provided in Section 1 will be made available to the public, which will include an entry on the Calderdale Sector Support website, and may be passed to West Yorkshire Police for inclusion on their community map(s). This is intended to help promote your organisation, its work and activities to the wider public of Calderdale and surroundings.

I am happy for the information contained in section 1 to be publicly available on:

The Sector Support Calderdale website: Yes No
West Yorkshire Police Leeds CAN: Yes No


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)

Name
Date
Organisation
Position in Organisation
Signature/Email

Please note, if returning this form electronically, the e-mail it is attached to can be taken in place of the signature where appropriate and if so indicated

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