Northumberland CVA

Member’s update form

Your organisation is a member if Northumberland CVA (previously known as Wansbeck CVS) and so we need to hold a certain amount of information about it. In order to ensure we comply with Data Protection regulations it is very important that the information we hold is correct and up to date and so we are asking you to complete and return this form with your current organisational details. Many of these questions simply require boxes to be ticked so the form should take no more than a few minutes to complete.

Northumberland CVA has recently updated its database system and is now able to offer its members entry into an online directory that will allow people to find you and access your services more easily. If you are interested in having your organisation’s details appear in the directory, please tick the relevant box below:

I do want my organisation to be listed in the Northumberland CVA online directory
I do not want my organisation to be listed in the Northumberland CVA online directory

Please be aware that the highlighted fields in this form are what will appear in the online directory if you have selected that option so please be sure that you are happy for these details to be made public. Please contact us for advice if you have any problems with this (01670 858688 or ).

There is a section at the end of this form for you to give individual contact details for the people in your organisation, which will not appear in the online directory.

Organisation contact details

Organisation Name
Organisation Address / Landline
Mobile
Email
Postcode / Website
Organisation aims and activities
Brief description for directory
(1-2 sentences only)
Opening hours / Areas covered / Central Northumberland
North Northumberland
South East Northumberland
Twitter details / West Northumberland
Northumberland-wide
Other North East area
Facebook details / Region-wide
National
Central Northumberland
Other social media sites your organisation can be found on / If you cover specific towns/parishes only, please specify

Services

Please tick the services you provide:
Accommodation / Education/training / Mentoring
Advice/information services / Employment / Out Of School Provision
Advocacy / Environment/conservation / Over 50s groups
Animal welfare / Faith/religion / Regeneration
Arts and media / Family services / Sexual health
Befriending / Financial services / Social activities
Business support / Funding and grants / Social and community care services
Campaigning / Health - general / Sports and leisure
Carers services / Homelessness / Substance misuse
Community development / Housing / Telephone helpline
Community services/facilities / International aid / Tenants and residents
Counselling and therapy services / IT / Translating/interpreting
Crime/community safety / Job search activities/job club / Transport
Day care services / Low income assistance / Voluntary & community sector support
Disability / Lunch clubs / Volunteering
Domestic abuse/sexual abuse / Mediation / Women’s issues
Education/childcare (pre-school, after school) / Mental health / Youth clubs/services
Other (please state):
Please tick all the client groups you support:
BAME / Black, Asian and Minority Ethnic / Lone parents / Socially inactive
Carers / People with long-term/chronic illness/health issue / Substance misusers
Childcare provision / Low income / Supported volunteering
Children / Men / Survivors of abuse/victims of crime
Disabled people (all) / Mental health problems (People with) / Tenants and residents
Employed / Migrants / Travellers
Faith groups / NEET / Unemployed
Families/parents / Offenders/ex-offenders / Voluntary and community groups
Gay /Lesbian/Bisexual/Transgender / Older people / Unsupported volunteering
General public / Over 50 / Volunteers
Homeless people / Physical/sensory impairments (people with) / Women
Housing support services (people receiving) / Refugees / Asylum Seekers / Young People
Learning Disabilities (People With) / Social entrepreneurs
Other (please state):

More about your organisation (N.B.: None of this information will appear in the online directory)

Please tick the income bracket your organisation falls into:
Under £1,000 / £50,000 - £99,999 / £500,000 - £1 Million
£1,000 - £9,999 / £100,000 - £249,999 / Over £1 Million
£10,000 - £49,999 / £250,000 - £499,999 / Unknown
Please tick the number of paid staff you have:
None / 6-10 / 21-50
1-5 / 11-20 / Over 50
Please tick the number of paid staff you have:
None / 6-10 / 21-50
1-5 / 11-20 / Over 50
Please tell us your organisation’s structure:
Branch of National Voluntary Organisation / Faith Group / Self Help Group
Development Trust / Infrastructure Organisation / Social Enterprise
Charitable Trust / Local Voluntary Organisation / Sports Club
Community Group / Network / Forum / Other
Please tell us your organisation’s legal status:
Charitable incorporated organisation / Company Limited by Guarantee / Registered Charity
Community interest company / Industrial and provident
Please tell us if your organisation holds any quality standard awards (e.g.: PQASSO, Investors in People, Matrix)

Do you offer venue facilities? If so, we can also put that information in the online directory. We are often looking for venues ourselves to use across the county so please do fill this section in if you have the facilities, even if you do not want to be part of the online directory.

Room 1 / Room 2 / Room 3
Room name: / Room name: / Room name:
Maximum capacity:
Minimum capacity:
Wheelchair access:
Hearing Loop:
Catering provided:
Details:
Refreshments provided:
Car parking:
Details:
Contact for booking:

Please let us know how to contact key people in your organisation - this may be the Chair or other trustees, the CEO, Manager, Volunteer Co-ordinator or other.

If you also want your trustees to be able to access the benefits of Northumberland Trustees’ Network, you can give us their details below rather than completing a separate application form.

N.B.: None of this information will appear in the online directory unless you have also entered it in the relevant fields above and have ticked that you want your organisation to be a part of the directory.

Name / Role / Email address / Phone number

Please sign below to confirm that the information you have given on this form is correct and up to date:

Authorised Signature:
Date:
Email address:

Thank you for your time. Please return this form to :

Northumberland CVA, 107 & 109 Station Road, Ashington, Northumberland, NE63 8RS or email it to .

If you’d like any further information, please call us on 01670 858688.