HELP YOURSELF - NEW ORGANISATION FORM

NAME OF ORGANISATION/ SERVICE / INDIVIDUAL :

DESCRIPTION :
(Please describe what you/ your organisation or service does. Please write your description in less than 1500 characters.)
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WHAT TYPE OF ORGANISATION ARE YOU?
(Are you voluntary, a charity, not-for-profit, statutory, Council, NHS, business, or any other? please state):

DO YOU CATER FOR ANY SPECIFIC GROUP?
(Eg do you cater for women only, men only, children of a certain age, older people? please state, including any ages or age ranges):

CONTACT DETAILS:

CONTACT ADDRESS:

IS THIS AN OFFICE ADDRESS? (please tick if yes)
IS THIS A PRIVATE ADDRESS? (please tick if yes)
DO YOU WANT THIS ADDRESS TO BE KEPT CONFIDENTIAL? (please tick if yes)

IF THIS IS AN OFFICE ADDRESS PLEASE GIVE OPENING TIMES:

PLEASE GIVE ANY DISABLED ACCESS DETAILS ABOUT THIS ADDRESS (if appropriate):

CONTACT NAME(S)(if appropriate):

CONTACT TELEPHONE NUMBER(S)
(give dialling codes, details about the number(s) eg. are they home numbers or work numbers?, when people can call etc):

CONTACT MOBILE NUMBER(S):

CONTACT FAX NUMBER:

CONTACT MINICOM NUMBER:

CONTACT EMAIL(S):

2nd CONTACT DETAILS (include name, tel no, mobile, email only):

ACTIVITY/ MEETING DETAILS (Please let us know details of where you meet or hold your activities):

Please include ADDRESSES, WHAT THE ACTIVITIES OR MEETINGS ARE and TIMES they are held. Also include CONTACT NAMES and TELEPHONE NUMBERS and ACCESS DETAILS ABOUT THE VENUE(S), if appropriate:

OTHER DETAILS ABOUT YOU/ YOUR ORGANISATION OR SERVICE:

WEBSITE:

LOCAL PUBLICATIONS:

COMMUNITY LANGUAGES OFFERED (including sign language):

CHARITY NUMBER (if appropriate):

COMPANY LIMITED BY GUARANTEE NUMBER (if appropriate):

ANNUAL GENERAL MEETING (please give the month when held, if appropriate):

Data Protection Statement:

The Information you give in this form will be made public, and it may be published by the City Council and the NHS, in any manner, including on the internet. By supplying this information and that of anyone else, you and they are consenting to this.

CONFIRMATION OF CONSENT
(please type your name and the date):

Pressing Submit will send an email from you to us. Warning boxes may appear, if you wish to continue, please click the "yes" button to send the email. Once you have clicked "yes" to send the email you will be returned to your filled in form.


Sheffield Information Service, Central Library, Surrey Street, Sheffield S1 1XZ, Tel: 273 4761 Fax: 275 7111 The Help Yourself Database is provided on the Internet as part of a joint project between Sheffield Libraries & Information Services,the Department of Information Studies at Sheffield University, Voluntary Action Sheffield and Sheffield NHS. Any comments or questions regarding the database should be sent to sis@sheffield.gov.uk