Hounslow Voice Network Membership Application Hounslow Voice Network Membership Application Question Title * 1. Name of organisation / group Question Title * 2. Contact name Question Title * 3. Position in organisation / group Question Title * 4. Address of organisation / group Question Title * 5. Postcode Question Title * 6. Telephone Question Title * 7. Email Please note that email is our main method of communication with the network. We encourage you to provide a contact email address if at all possible. Question Title * 8. Website Question Title * 9. Brief description of what your group/organisation does (max 100 words) Question Title * 10. Legal status of organisation/group(tick all that apply) Registered Charity Company Limited by Guarentee Friendly Society Unincorporated Association Other If other, please specify Question Title * 11. Is your group based in Hounslow? Yes No Question Title * 12. If you answered no to Qu 11, does your group work in Hounslow? Yes No (If you answer No to both Qu 11 & Qu. 12 you are, unfortunately, not eligible for HCN Membership. Contact iain@ealingcvs.org.uk for more information.) Question Title * 13. In which of the five area committees of Hounslow are you operating/based? Central Hounslow Heston & Cranford West Area Chiswick Brentford & Isleworth Question Title * 14. How many paid staff members does your organisation have? (1 full-time member is the equivalent of 35hrs) Less than or equal to 1 full-time equivalent Between 1-5 full-time equivalent Over 5 full time equivalent Question Title * 15. Select up to five "work areas" from the options below, marked 1 to 5 (1 being your highest priority), which your group/organisation is most involved with. 1 2 3 4 5 Animal Welfare Animal Welfare 1 Animal Welfare 2 Animal Welfare 3 Animal Welfare 4 Animal Welfare 5 Arts & culture Arts & culture 1 Arts & culture 2 Arts & culture 3 Arts & culture 4 Arts & culture 5 BMER BMER 1 BMER 2 BMER 3 BMER 4 BMER 5 Children Children 1 Children 2 Children 3 Children 4 Children 5 Dispute Dispute 1 Dispute 2 Dispute 3 Dispute 4 Dispute 5 Education Education 1 Education 2 Education 3 Education 4 Education 5 Environmental sustainability Environmental sustainability 1 Environmental sustainability 2 Environmental sustainability 3 Environmental sustainability 4 Environmental sustainability 5 Families Families 1 Families 2 Families 3 Families 4 Families 5 Health & Wellbeing Health & Wellbeing 1 Health & Wellbeing 2 Health & Wellbeing 3 Health & Wellbeing 4 Health & Wellbeing 5 Learning Disability Learning Disability 1 Learning Disability 2 Learning Disability 3 Learning Disability 4 Learning Disability 5 Legal Advice Legal Advice 1 Legal Advice 2 Legal Advice 3 Legal Advice 4 Legal Advice 5 LGBT LGBT 1 LGBT 2 LGBT 3 LGBT 4 LGBT 5 Marriage / Civil Marriage / Civil 1 Marriage / Civil 2 Marriage / Civil 3 Marriage / Civil 4 Marriage / Civil 5 Men Men 1 Men 2 Men 3 Men 4 Men 5 Mental Health Mental Health 1 Mental Health 2 Mental Health 3 Mental Health 4 Mental Health 5 Older People Older People 1 Older People 2 Older People 3 Older People 4 Older People 5 Partnership Partnership 1 Partnership 2 Partnership 3 Partnership 4 Partnership 5 Physical Disability Physical Disability 1 Physical Disability 2 Physical Disability 3 Physical Disability 4 Physical Disability 5 Religion or Belief Religion or Belief 1 Religion or Belief 2 Religion or Belief 3 Religion or Belief 4 Religion or Belief 5 Resolution / Mediation Resolution / Mediation 1 Resolution / Mediation 2 Resolution / Mediation 3 Resolution / Mediation 4 Resolution / Mediation 5 Sport Sport 1 Sport 2 Sport 3 Sport 4 Sport 5 Training Training 1 Training 2 Training 3 Training 4 Training 5 Women (inc. pregnancy / maternity) Women (inc. pregnancy / maternity) 1 Women (inc. pregnancy / maternity) 2 Women (inc. pregnancy / maternity) 3 Women (inc. pregnancy / maternity) 4 Women (inc. pregnancy / maternity) 5 Youth Youth 1 Youth 2 Youth 3 Youth 4 Youth 5 Other (Please specify) Other (Please specify) 1 Other (Please specify) 2 Other (Please specify) 3 Other (Please specify) 4 Other (Please specify) 5 Other (please specify) Question Title * 16. If you would like to know more about how we deal with your data and would like to know how to contact us regarding this and any other personal data issue please follow this link to our website and Privacy Statement. Click Here Next