LINks Stockports community voice

Untitled Document

Application for membership & participant individuals

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

Contact Name:

Date of Birth:

Address:

Post code:

Contact Telephone:

Email Address :

How do you hear about the LINk?

How would you like best to receive the newsletter?

Email
Post
Post for larger correspondence

How would you like best to be kept informed?

Email
Post
Via the Website
Over the Phone
Text Message Service
Other

Section 2. 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 foward 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 questionaires 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.

3. Do you have any skills that you would like to share?

The LINk may contact you from time to time when we feel there is something you can be involved with.

I AM GOOD AT AND ENJOY:

Computing

Training

Admin

Proof Reading

Writing Articles

Coaching

Researching

Planning

Leading a team

Being part of a team

designing

Listening

Problem solving

Presenting

Observing

Creating

Logical

Running Groups

Project Planning

Talking to People

Other :

N/A

Section 4. What areas do you have experience in?

The LINk would like know about your current or past experience that you feel benefits you as a LINk member?

I HAVE HAD EXPERIENCE IN:

Being a carer

Being a parent

Working in health care

Working in social care

Volunteering in health care

Volunteering in a social care setting

Volunteering in another setting

Working in training

Working in finance

Working in publicity & promotion

Working in education

Working as a councillor

Other sector eg. Police, Fire

Other:

Section 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.

MY INTERESTS INCLUDE:

Carers

Cancer Services

Children

Cultural Health

Dentist

Drug Abuse

Discrimination in health & social care

End of life care

General care

GP services

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 disability

Sensory disability

Woman's health & social care

Young people

Other

Section 6. Do you have an association with any other communities or groups?

No
Yes (please expand)

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