/ New group form

Newcastle CVS provides free support and services for voluntary, community and not-for-profit organisations that work in Newcastle. To be able to work with you, we need some basic information about your organisation. Please make sure you complete all the sections in red.

Section one / Contacting your organisation
1.1 / Organisation contact details
Organisation name
Organisation’s address
Street
Town / Postcode
Telephone number / Fax number
Email address
Website
Is your organisation known by any other names (former names, abbreviations)?
1.2 / Main contact
First name / Last name
Role within organisation
Email address
Yes / No
Can we contact you by email?
Your email address will not be made public.
Section two / What your organisation does
2.1 / What do you do?

Please give a short description (up to 100 words) of your organisation, its work and who it works with.

2.2 / Where doesyour group work?

Please tick where you work

Part of Newcastle (see below) / All or part of north east
All of Newcastle / All or part England or UK
All or part of Tyne and Wear / Other (please write in)

If you only work in specific areas of Newcastle, please tick which ward/wards

Benwell and Scotswood / Fenham / South Jesmond
Blakelaw / Kenton / Walker
Byker / Lemington / Walkergate
Castle / Newburn / West Gosforth
Dene / North Heaton / Westerhope
Denton / North Jesmond / Westgate
East Gosforth / Ouseburn / Wingrove
Elswick / Parklands / Woolsington
Fawdon / South Heaton
2.3 / What are your main services or areas of work?

Please mark in number order your organisation’s main focus (up to four) where 1 is main focus.

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

Do you work with all client groups?

Yes / No (please tick below)

Are your services aimed at particular groups of people?

Please tick up to four groups and only tick those client groups that you mainly work with.

For example, if your organisation provides mental health services open to everyone, only tick ‘mental health problems’. If you deliver a mental health service specifically for women who use drugs, you would tick mental health problems, substance misusers,women.

Asylum seekers and/or refugees / Offenders and/or ex-offenders
Black and ethnic minority (all) / Older people
Carers / Physical disabilities (people with)
Children (0 -14) / Sensory impairment (people with)
Disabled people (all) / Social entrepreneurs
Employed / Substance misusers (drugs/alcohol)
Faith groups / Survivors of abuse/victims of crime
Families and/or parents / Tenants and residents
Gay/lesbian/bisexual/transgender / Unemployed
Gypsies and travellers / Voluntary and community groups
Homeless people / Volunteers
Learning disabilities (people with) / Women
Lone parents / Young people (14-19)
Long-term/chronic illness (people with) / Other (please specify)
Low income (people with)
Men
Mental health problems (people with)
Section three / About your organisation

Information contained in this section will be used for monitoring and administration purposes and to help us to target our services appropriately. It will also be used to provide general statistics about voluntary and community organisations that we work with, for example, how many organisations employ staff.

3.1 / What is your organisation’s type and legal structure (tick all that apply)
Community group / Unincorporated association
Faith group / Charitable trust
Self-help/service-user led / Social enterprise
Community forum/development trust
Company limited by guarantee / Registered charity
(please write company number below) / (please write charity number below)
Community interest company / Charitable Incorporated Organisation
(please write CIC number below) / (please write CIO number below)
Other organisation type
(please write in)
3.2 / How many staff does your organisation currently employ?
None / 1-5 / 6-10
11-20 / 21-50 / Over 50
3.3 / How many people are currently volunteering with your organisation, including trustees and management committee members?
None / 1-5 / 6-10
11-20 / 21-50 / Over 50
3.4 / What is your organisation’s approximate annual income from all sources?

This will only be used by Newcastle CVS to target our services to you and to provide anonymous general statistics about Newcastle’s voluntary and community sector. It will not be made public.

Under £1,000 / £50,001 - £100,000 / £500,001 - £1 million
£1,001 - £10,000 / £100,001 - £250,000 / Over £1 million
£10,001 - £50,000 / £250,001 - £500,000
Section four / Your support needs
Yes / No
Does your organisation have any other support and development needs?
If yes, we can help so please tell us below and we will contact you
Section five / ncvs e-inform sign up

ncvs e-informis the main way we communicate with the organisations we work with in Newcastle. By signing up to ncvs e-informyou can find out about our services, the latest VCS news, and information about funding, resources, events and training. We also publicise our newsletter, training programme and all our publications through the weekly email bulletin.

Yes / No
I’d like to receive ncvs e-inform, Newcastle CVS’s weekly email bulletin
If yes, make sure you’ve given us your email address in question 1.2. Ifother people in your organisation would also like to receive ncvs e-inform, please write their name and email addresses below
Section six / How we will use your information

The information you have given on this form will be added to Newcastle CVS’s database so we contact you, work with you and provide information you request. Newcastle CVS complies fully with the Data Protection Act. Please ask if you’d like to see our data protection policy.

Section seven / Your signature

We confirm that Newcastle CVS can hold our information on Newcastle CVS’s database and accept the terms in Section six: How we will use your information.

Signed / Name (please print)
Date / Role in organisation

Returning this form

paper versions can be given to the Newcastle CVS staff member you are working with or posted to JudithTemple, Newcastle CVS, MEA House, Ellison Place, Newcastle upon Tyne NE18XS

electronic versions can be emailed to to save postage. Please email Judith if you’d like a Word version

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