LINks Stockports community voice

Untitled Document

Application for membership & participant for groups,
organisations & business

Please use the form provided below to apply directly online or if you prefer you can download a hard copy by clicking here.

Section 1: About you
We are:	A Community Group A Voluntary Organisation A Business Other (please state below)
Name of LINk contact:
Name of group, organisation or business:
Name of Chair / Director / Chief Executive:
Address:


Post code:
Contact Telephone:
Email Address :
How do you hear about the LINk?
Do you have time/resources to give the LINk about issues which may affect the people you work with? Please give details.
2. What is the main focus of your group or organisation
All people Children Young people Older people Women Men Religious People with disabilities Carers BME Groups Volunteers Patients Health Social Care Mental Health Other
3. Membership
How big is you group membership?	1-10 11-20 21-30 31-40 41-50 51-99 100+ 200+
Section 4. Organisations & Businesses
How many members of staff work for your group?	1-10 11-20 21-30 31-40 41-50 51-99 100+ 200+
How many volunteers?	1-10 11-20 21-30 31-40 41-50 51-99 100+ 200+
5.What areas are you interested in? The LINk would like to know what areas you are interested in so that we can send you any relevant information and anything that may be of interest to you. OUR INTERESTS INCLUDE
Carers Cancer Services Children Cultural Health Dentist Drug Abuse Discrimination in health & social care End of life care General care Health promotion Hospital services Infection control Long term care Prison health Long term conditions learning disabilities Men's health & social care Mental Health Older People Opticians Sexual health Physical disabilities Sensory disabilities Woman's health & social care Youth people Other :
Section 6. Which activities would you like to be involved in? It is up to you how much or how little you get involved. Below are some of the different ways you may like to get involved. Training & Personal development will be provided. I AM INTERESTED IN (TICK ANY THAT APPLY):
Receiving the Stockport LINk newsletter
Attending public events hosted by the LINk
Providing the LINk with my views from time to time.
Being a LINk Core Group Member
Being part of a task group.
Contributing in designing and developing a questionnaire or survey
Arranging a time limited or one off focus group or a series of discussion groups.
Helping others get involved in consultations of planning and developing services.
Attending meetings or events to represent the LINk.
Receiving the LINk Core Group Minutes
Giving talks about the LINk on behalf of the LINk or help with training
Being a key representative to put forward a the views of your group, organisation or business.
Taking part in discussions or focus groups.
Taking part in anonymous interviews about my personal experiences
Answering surveys and questionnaires from time to time.
Volunteer to support the LINk office.
Becoming part of a reading group
Receive training to become an authorised representative of the LINk to visit health and social care premises.
Section 7. What areas of stockport do you cover? All of Stockport Particular area (please state)
How would you like best to be kept informed?	Email Post Via the Website Over the Phone Other

Many thanks for your time. The data you provide will be used to contact you about Local Involvement Networks or other health and social care issues and will be stored in accordance with the Data Protection Act.

Stockport LINk is supported through Pebble Enterprises
Co No 06506546, Charity No 1139131