If you would like access to our Members Area, please complete the Registration Form below:

Section A

NOTE: Information given within this section may be published, or passed onto other relevant agencies

ORGANISATION DETAILS

 
Name of Organisation / Group:
Address of Office:
Postcode
Contact Telephone:
Fax Number:
Email:
Website Address
Hours of Opening:
Disabled Access:  



Address of Meeting Place with Postcode:
(If different from above)
    

Hours of Opening:
Disabled Access:  

 
CONTACT DETAILS
Contact Name:              
Position in Group:
Address with Postcode: 
(If different to above)
Telephone Number:

ACTIVITIES/STAKEHOLDERS
Describe the main activities of your group:

Which age groups does your organisation represent?
(Tick all appropriate boxes)

Pre-school
5 - 12
12-18
19-25
26-45
46-60
Over 60
All Ages
Geographical Area Covered:
(i.e. Cumnock, Kilmarnock North, East Ayrshire. etc)
Which groups does your organisation represent? 
(Tick all appropriate boxes)
Elderly Youth Unemployed
Art/Theatre Education/Training Social
Community Male Female
Physical Disability Learning Difficulty Health Related
Drug & Alcohol Dependency Sensory Impairment Autism/ADHD
Mental Health Domestic Violence Victims

Low Income/
Poverty Action
Tenants Associations Bereaved Victims of Crime
Terminally Ill Single Parents Family Support
Consumer Right Head Injuries    

 

 
   

Section B

NOTE:No information solely given within this section will be published.
ORGANISATION DETAILS
Name of Organisation / Group:
Aims / Objectives:

 
Please select all that apply below.
YES
NO
MAYBE

Is your organisation a registered charity?

Is your organisation a company limited by guarantee?

Does your organisation have its own premises?

Does your organisation have insurance?
If yes, does it include employee and public liability?

Does your organisation work with children or vulnerable adults?

Do you have a Child Protection Policy?

Do you undergo SCRO Checks?
Do you currently pay for these checks?
What sort of Management Structure does your organisation have
Board Committee Common Bond Area

STAFFING
Does your organisation employ staff? YES NO
If yes, how many Part time Full time


FUNDING / INCOME

Which of the following funding sources does your organisation receive financial support from? (Tick all that apply)

Self Financing

 Membership Dues Service Fees Fundraising Actvities
Local Authority Trusts European Funding    
Would your organisation like assistance with funding applications? YES NO


What is the annual income of your organisation?
(Tick appropriate box)

Below £999

£1,000 - £4,999

£5,000 - £9,999

£10,000 - £19,000

£20,000 - £34,999

£35,000 - £49,999

£50,000 - £99,999

 Over £100,000    


TRAINING

  
Does your organisation provide any training for staff / volunteers? YES NO
 
   
The information in Section A will be kept on a database would you agree to this information being passed onto other relevant agencies YES NO

Thank you for your assistance in completing this form. The information contained in Section B will be treated in confidence.  
Should you require help in completing the form or wish to find out more information on CVO (EA) Ltd, please contact the office.