Hive Referral Form

Hive referral form

Group or Project Date

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Referred by:

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Applicant Referrer

Forename Surname Forename Surname

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Address Organisation Address

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Postcode / Click here to enter text. / Postcode / Click here to enter text. /

Telephone Telephone

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Email Email

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How did you hear about us? How did you hear about us?

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Would you like to join our mailing list? / Choose / Would you like to join our mailing list? / Choose /

Please give details of any interest in art and creative activities

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Please give details of any mental health conditions that could impact on your time working with Hive.

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Do you have any physical health problems that could impact on your time at Hive?

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Is there any particular support you will need while working with Hive?

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Is there anything that could affect your or other people's safety while working with Hive, e.g. side effects of medication?

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How does Hive use my information?

We use it to inform you about our services, activities and courses.

We make reports to our funders using anonymised data.

We will not share your data with anyone else unless we have a legal duty to do so.

We will keep your data while you are active at Hive and for up to three years afterwards.

If you want to see the information we hold about you can ask us in writing.

You can ask us to correct or remove information we hold about you at any time.

I agree to Hive processing my data as described / Select /
I agree to Hive contacting me by telephone / Select /
I agree to Hive contacting me by email / Select /
Entered on database by: / Click here to enter text. / Date / Select /