Request For Support Form Survey

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* 1. Name of your group (write "setting up" if you are in the process of setting up)

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* 2. Your name

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* 3. Your role in the group

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* 4. Your contact phone number

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* 5. Your contact email address

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* 6. Your contact address

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* 7. Your postcode

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* 8. How is your group set up?

Not from a group, I am an individual

Community group without a constitution

Community group with a constitution

Company Limited by Guarantee

Community Interest Company

Registered Charity

Registered Charity and company (Charitable Company)

Charitable Incorporated Organisation

Co-operative or IPS

Other (please specify)

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* 9. Where do your services primarily take place in?

Nottingham City

Nottinghamshire

Nationally

Internationally

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* 10. Are your services primarily aimed at any of the following groups? (please tick as many boxes that apply)

BAME (Black, Asian & Minority Ethnic)

Women

Disability (including mental health and learning difficulties)

Older People with health issues

Lesbian, Gay, Bisexual and Transgender People

Refugee or Asylum Seekers

Men

Children and Young People

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* 11. What activities or services are you running/plan to run? How will they help the community?

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* 12. How many beneficiaries does your group currently work with? Please write the approximate number in the box below.

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* 13. Can you rate on a scale of 1-6 whether the following areas are a concern for your organisation, with 1 being of least concern and 6 being of most concern

	1	2	3	4	5	6
Funding - applying for grants	Funding - applying for grants 1	Funding - applying for grants 2	Funding - applying for grants 3	Funding - applying for grants 4	Funding - applying for grants 5	Funding - applying for grants 6
Funding – writing tenders	Funding – writing tenders 1	Funding – writing tenders 2	Funding – writing tenders 3	Funding – writing tenders 4	Funding – writing tenders 5	Funding – writing tenders 6
Governance – having the right legal structure	Governance – having the right legal structure 1	Governance – having the right legal structure 2	Governance – having the right legal structure 3	Governance – having the right legal structure 4	Governance – having the right legal structure 5	Governance – having the right legal structure 6
Governance –role and responsibilities of trustees / directors	Governance –role and responsibilities of trustees / directors 1	Governance –role and responsibilities of trustees / directors 2	Governance –role and responsibilities of trustees / directors 3	Governance –role and responsibilities of trustees / directors 4	Governance –role and responsibilities of trustees / directors 5	Governance –role and responsibilities of trustees / directors 6
Impact – being able to demonstrate the impact of your work	Impact – being able to demonstrate the impact of your work 1	Impact – being able to demonstrate the impact of your work 2	Impact – being able to demonstrate the impact of your work 3	Impact – being able to demonstrate the impact of your work 4	Impact – being able to demonstrate the impact of your work 5	Impact – being able to demonstrate the impact of your work 6
Marketing – identifying your market	Marketing – identifying your market 1	Marketing – identifying your market 2	Marketing – identifying your market 3	Marketing – identifying your market 4	Marketing – identifying your market 5	Marketing – identifying your market 6
Marketing – promoting your work e.g. publicity, social media	Marketing – promoting your work e.g. publicity, social media 1	Marketing – promoting your work e.g. publicity, social media 2	Marketing – promoting your work e.g. publicity, social media 3	Marketing – promoting your work e.g. publicity, social media 4	Marketing – promoting your work e.g. publicity, social media 5	Marketing – promoting your work e.g. publicity, social media 6
Planning – having a clear strategic plan	Planning – having a clear strategic plan 1	Planning – having a clear strategic plan 2	Planning – having a clear strategic plan 3	Planning – having a clear strategic plan 4	Planning – having a clear strategic plan 5	Planning – having a clear strategic plan 6
Policies and procedures – having the right ones in place, reviewing & updating	Policies and procedures – having the right ones in place, reviewing & updating 1	Policies and procedures – having the right ones in place, reviewing & updating 2	Policies and procedures – having the right ones in place, reviewing & updating 3	Policies and procedures – having the right ones in place, reviewing & updating 4	Policies and procedures – having the right ones in place, reviewing & updating 5	Policies and procedures – having the right ones in place, reviewing & updating 6
Staffing – recruitment	Staffing – recruitment 1	Staffing – recruitment 2	Staffing – recruitment 3	Staffing – recruitment 4	Staffing – recruitment 5	Staffing – recruitment 6
Staffing – supervision, managing staff performance	Staffing – supervision, managing staff performance 1	Staffing – supervision, managing staff performance 2	Staffing – supervision, managing staff performance 3	Staffing – supervision, managing staff performance 4	Staffing – supervision, managing staff performance 5	Staffing – supervision, managing staff performance 6
Quality assurance – implementation of recognised standards	Quality assurance – implementation of recognised standards 1	Quality assurance – implementation of recognised standards 2	Quality assurance – implementation of recognised standards 3	Quality assurance – implementation of recognised standards 4	Quality assurance – implementation of recognised standards 5	Quality assurance – implementation of recognised standards 6
Volunteers – recruitment	Volunteers – recruitment 1	Volunteers – recruitment 2	Volunteers – recruitment 3	Volunteers – recruitment 4	Volunteers – recruitment 5	Volunteers – recruitment 6
Volunteers – supervision and retention	Volunteers – supervision and retention 1	Volunteers – supervision and retention 2	Volunteers – supervision and retention 3	Volunteers – supervision and retention 4	Volunteers – supervision and retention 5	Volunteers – supervision and retention 6
Working in partnership	Working in partnership 1	Working in partnership 2	Working in partnership 3	Working in partnership 4	Working in partnership 5	Working in partnership 6

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* 14. Please tell us about what it is you are looking for support with. In order for us make an informed decision please provide as much information as you can.

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* 15. Please tell us the likely difference the work requested will mean to the running of your group.

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* 16. Can we refer you to more appropriate of specialist support if we consider that this will better meet your support needs?

Yes