CommUNITY Barnet

Organisation Name *

Postal Address *

Postcode *

Telephone *

Fax

Email *

Tick here if you DO NOT wish to receive CommUNITYBarNET (weekly e-newsletter)

Website

Minicom

Other Contact Information

CommUNITY Barnet correspondence will be sent to the main contact and address above. If there are other people in your organisation who should receive specific information, please give details:

Contact for receiving CommUNITY Barnet mailings, including LINK:

Full Name

Position

Telephone

Email

Contact for information on training, meetings and events:

Full Name

Position

Telephone

Email

Contact for volunteering:

Full Name

Position

Telephone

Email

If your Chair wishes to receive relevant information at a different address, please give contact details below if different to above

Name of Chair

Contact Address

Postcode

Email

Organisation Details

How long ago was your organisation established?

/ /

Approximate current annual income
(please give an estimate or budget, if you are a new organisation)

Number of Service users

Number of paid staff

Number of volunteers

Organisation Activities

Venue: Please give the name and address details of your meeting place if different to your contact address.

Premises Name:

Premises Address:

Postcode

Please give a brief description of the activities your organisation is involved in

Who does your organisation work with?

What is the ethnicity of the groups you work with?

What is the religion/belief of the groups you work with?

What are your main sources of funding?

In which geographical area(s) does your organisation operate?

Which community networks are you involved in?

How does your organisation deliver its services?

What type of service does your organisation deliver?

What services would you want from us? Please tick the ones relevant to your organisation
(This information will help identify which member option is best suited to your organisation)

Are you interested onsite group session? (please specify area):

Any other services (please specify):

How did you find out about CommUNITY Barnet (membership)?
Please tick & specify

CommUNITY Barnet Event
CommUNITY Barnet Link/leaflet
E-newsletter/Website
Recommendation/Referral
Other