Scottish Council on Deafness

Scottish Council on Deafness

SCoD Membership Application

Thank you for your interest in becoming a member of the Scottish Council on Deafness (SCoD). There are two types of membership available to organisations, and one for individuals.

Associate Member / Full Member
Organisations and Individuals.
·  Assistance with self-evaluation.
·  Up to 4 hours of capacity building tuition, free of charge.
·  Invitations to SCoD Think Days for two people.
·  10% discount on stalls at SCoD Conferences.
·  Invitations to inter-sector/government networking.
·  Submit two articles to Newsletter.
·  Unlimited articles in bulletin.
·  10% discount on extra adverts in SCoD information services. / Organisations only.
Associate member benefits plus:
·  Full voting rights at SCoD National Council meetings.
·  Stand for election to SCoD Board.
·  Assistance with project/organisation evaluation.
·  Up to 8 hours of capacity building tuition, free of charge.
·  Set the agenda at SCoD Think Days.
·  10% discount on SCoD Conference and Award Ceremony tickets. 10% stall discounts.
·  Unlimited articles in bulletin.
·  10% discount on extra adverts in SCoD information services.
£20 / See table below and indicate appropriate band
Band / Income/Turnover / Fee
1 / Up to £50,000 / £50
2 / Up to £100,000 / £100
3 / Up to £250,000 / £125
4 / Up to £500,000 / £150
5 / Up to £1 million / £200
6 / Over £1 million / £300
Section one: Membership type
1 – I wish to apply for:
Full membership: / Associate membership:
Section two: Organisation details

2 – Please enter the contact details for your organisation (or your organisation’s Scottish office) here:

Name of organisation:
Chief Executive/ Director/ Manager:
Address line one:
Address line two:
Town/City:
Postcode:
Telephone:
Textphone:
Mobile:
Fax:
Email address:
Website:

3a – If applicable, please provide the contact details for your Chair/Convenor of Board:

First name / Last name / Email address

3b – Please enter the first name, last name and email address of the person who oversees the following areas, if applicable:

First name / Last name / Email address
Equality and Diversity:
Human Resources:
Finances:
Communications/PR:
Policy:
Other. Specify:
(______)

4 – Please enter here the contact details of who you want to nominate to formally represent your organisation at the SCoD meetings:*Full membership only*

First name:
Surname:
Job title:
Work address line one:
Work address line two:
Work postcode:
Telephone:
Textphone:
Mobile:
Fax:
Email address:
Language/communication
Support needs:

5 – Please indicate whether your organisation’s nominated representative is:

Deaf BSL user: / Deafblind:
Hard of Hearing: / Deafened:
Hearing with no sight loss: / Hearing with sight loss:

6 – What is your organisation’s main sector of business?

Public: / Private: / Third:

7a – What is your organisation’s stated purpose?

7b – What kind of services does your organisation provide for deaf people, if any? For example social work, interpreting, accessible information, etc.

7c – If applicable, please indicate approximate numbers of people who are deafened, deafblind, hard of hearing or Deaf BSL users who use your service(s)?

Deafened: / Deafblind:
Hard of Hearing: / Deaf BSL Users:

8 – Please tick all that apply to your organisation:

Charity: / Voluntary Association:
Registered Company: / ALIO:
SCIO: / Public body:
Other (Please specify):

9 – Please enter any of the following if applicable:

Scottish Charity Number:
Registered Company Number:

10 – How many of each of the following do you employ:

Full time staff (35+ hours):
Part time staff (Less than 35 hours):
Volunteers (Excluding Management Committee/Board members):
Management Committee/Board members:

11 – What is the geographical extent of your activities? (Tick all that apply)

Aberdeen City Council / Comhairle nan Eilean Siar / Renfrewshire Council
Aberdeenshire Council / Falkirk Council / Scottish Borders Council
Angus Council / Fife Council / Shetland Islands Council
Argyll & Bute Council / Glasgow City Council / South Ayrshire Council
Clackmannanshire Council / Highland Council / South Lanarkshire Council
Dumfries & Galloway Council / Inverclyde Council / Stirling Council
Dundee City Council / Midlothian Council / West Dunbartonshire Council
East Ayrshire Council / Moray Council / West Lothian Council
East Dunbartonshire Council / North Ayrshire Council / Scotland wide:
East Lothian Council / North Lanarkshire Council / UK wide:
East Renfrewshire Council / Orkney Islands Council / International:
Edinburgh City Council / Perth & Kinross Council

12 –Please enter a postal address for an invoice to be mailed to if it is not the same as either your organisation’s or your nominated contact’s work postal address:

Address line one:
Address line two:
Town/City
Postcode:

Note for first time applicants only: In order to process your application, it would be helpful to have a copy of your organisation’s most recent audited annual accounts. Also, if possible, a copy of your organisation’s founding document: e.g. Constitution, Memorandum and Articles of Association, etc.

Section three: About your organisation

13 – What is your organisation’s interest(s) in deafness?

Accessibility: / Community involvement:
Policy and legislation: / Products and services relating to deafness:
Research and academia: / I am deaf:
Training: / I have a deaf friend/ relative:
Other (Please specify):

14 – What is your organisation’s reason(s) for joining SCoD?

SCoD Publications: / I am deaf:
Networking opportunities: / I have a deaf friend/ relative:
Advice on accessibility: / My reasons are academic:
Influencing policy:
Other (Please specify):

15 – Where did you hear about SCoD?

SCoD Bulletin: / SCoD event:
SCoD Newsletter: / Other event:
From a friend/ relative: / SCoD staff:
From a local organisation: / SCoD website:
Public meeting:
Other (Please specify):
Section four: Fee type and payment

18 – (a) Please indicate whether you have paid by cheque or by BACs.

Cheque: / BACs:
Our bank account details for BACs payments are:
Bank: / The Royal Bank of Scotland
Account name: / Scottish Council on Deafness
Sort code: / 83 51 00
Account number: / 15417160

19 – Would you like to receive an invoice for your membership payment?

Yes: / No:
Section five: Disclaimer

SCoD will ensure that the information entered here will be kept private and confidential in accordance with the Data Protection Act 1998.

The applicant declares that, to the best of their recollection, the information provided in this application form is correct and most up to date. The applicant understands that that any failure to provide correct and up to date details can result in delays in membership acceptance and possibly refusal.

In accordance with the SCoD Constitution:

“6(f) - The National Council shall have the right for good and sufficient reason to terminate the membership of any organisation provided that the individual representing such organisation shall have the right to be heard by the National Council before a final decision is made.”

Signed:
Name of applicant:
Job title:
Date:

Thank you for your application. Please mail this membership application form to the postal address found below, or alternatively you can email a scanned copy to .

Scottish Council on Deafness
Central Chambers
Suite 62, 1st Floor
93 Hope Street
Glasgow
G2 6LD
Telephone: 0141 248 2474
Textphone: 0141 248 2477
Fax: 0141 248 2479

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