Scottish Co-production Network - Registration Form

Registration form

Please complete the questions below to register as a member of the Scottish Co-production Practitioners Network.

You may already be a member and have emailed your details in the past year, however in order to update the membership list we would be grateful if you could re-register your details so that we know you still wish to be a member for 2012/13 and that we have the correct details for you.

If you have any questions at all, please don't hesitate to get in touch.
olivia@scdc.org.uk / 0141 222 4839.

Thanks!

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* Please provide us with your personal details. This will be shared with other network members so please only give details you wish to be shared with the network.

First name

Surname

Position/volunteer

Organisation/company

Confirm email

Phone number

Address

Postcode

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* Please briefly describe the nature of your organisation.
You might want to tell us here if you are representing more than one organisation/ network.

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* Please tell us what you can contribute to the network?

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* The network will host a series of action learning sets and possibly a national conference/ seminars as well as 3 more meetings in 2012/13.

Please indicate to what extent you will be able to assist with these.

	I would attend and assist with facilitation as necessary	I would like to contribute to the planning
Action Learning Sets (likely to be a half day, themed, possibly at regional level)	Action Learning Sets (likely to be a half day, themed, possibly at regional level) I would attend and assist with facilitation as necessary	Action Learning Sets (likely to be a half day, themed, possibly at regional level) I would like to contribute to the planning
National seminar/conference (full day potentially)	National seminar/conference (full day potentially) I would attend and assist with facilitation as necessary	National seminar/conference (full day potentially) I would like to contribute to the planning

Please comment if you would like to help plan any of these events

Question Title

* Please suggest any themes for the action learning sets.

The proposed format is to identify themes to which co-production can be applied, e.g. early years, older people's services, mental health, disability, additictions. And to identify a facilitator for each set who can demonstrate authority on the theme or give practical examples of co-production in practice.

So please also suggest (or volunteer for!) facilitation for your suggested themes if you can.

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* Would your organisation be able to provide meeting space if necessay for network meetings (of approx 20 people)? If so, where?

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* What would be useful for you in terms of the network website which we have been resourced to develop?

	Yes would definitely use it	Might use it	Not very likely to use it
a site which I can register, and manage my preferences myself	a site which I can register, and manage my preferences myself Yes would definitely use it	a site which I can register, and manage my preferences myself Might use it	a site which I can register, and manage my preferences myself Not very likely to use it
a library space where I can access and upload relevant documents	a library space where I can access and upload relevant documents Yes would definitely use it	a library space where I can access and upload relevant documents Might use it	a library space where I can access and upload relevant documents Not very likely to use it
a member's forum where I can start discussions, share links and contact other members	a member's forum where I can start discussions, share links and contact other members Yes would definitely use it	a member's forum where I can start discussions, share links and contact other members Might use it	a member's forum where I can start discussions, share links and contact other members Not very likely to use it
a newsletter/ events stream to my inbox	a newsletter/ events stream to my inbox Yes would definitely use it	a newsletter/ events stream to my inbox Might use it	a newsletter/ events stream to my inbox Not very likely to use it
enabled links to social media, e.g. Twitter, Facebook, Youtube etc	enabled links to social media, e.g. Twitter, Facebook, Youtube etc Yes would definitely use it	enabled links to social media, e.g. Twitter, Facebook, Youtube etc Might use it	enabled links to social media, e.g. Twitter, Facebook, Youtube etc Not very likely to use it

Please share any ideas you have about the website design

Question Title

* Please provide us with your personal details. This will be shared with other network members so please only give details you wish to be shared with the network.

Question Title

* Please briefly describe the nature of your organisation. You might want to tell us here if you are representing more than one organisation/ network.

Question Title

* Please tell us what you can contribute to the network?

Question Title

* The network will host a series of action learning sets and possibly a national conference/ seminars as well as 3 more meetings in 2012/13. Please indicate to what extent you will be able to assist with these.

Question Title

Question Title

* Would your organisation be able to provide meeting space if necessay for network meetings (of approx 20 people)? If so, where?

Question Title

* What would be useful for you in terms of the network website which we have been resourced to develop?

Question Title

* Any other comments/suggestions for the network?

* Please briefly describe the nature of your organisation.
You might want to tell us here if you are representing more than one organisation/ network.

* The network will host a series of action learning sets and possibly a national conference/ seminars as well as 3 more meetings in 2012/13.

Please indicate to what extent you will be able to assist with these.