Form

Voluntary Action Calderdale Database Form
VAC’s Database has been built and developed to collate a comprehensive record of organisations and contacts, mainly in Calderdale, but also in surrounding boroughs and nationally. These records may be used in 2 ways.
1. Basic information (service area, contact details and web address) CAN BE MADE AVAILABLE ON THE WORLD WIDE WEB for the general public to find out about your organisation and what it does.
2. The information provided will be used solely by VAC as part of their work providing services to voluntary organisations. The information will be used by VAC to send your organisation relevant information and for monitoring purposes only.
Data Protection*

Please include our organisation on the public database We only wish for our data to be used by V.A.C
Organisation*
Primary Contact Full Name*
First Name Last Name
Role
Secondary Contact Full Name
First Name Last Name
Role

Organisation Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Please tick if this is a personal home or service address

Personal Service
Is this the address that you would be happy to receive mail to?

Yes No

If no, please provide an alternative address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail
Phone Number
- Area Code Phone Number
Mobile
Please tick if either phone number is personal and it will not be made public

Phone Number Mobile
Website
About your group/organisation and the services/activities offered
Which day/s does your organisation work?

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Best time to contact
Via

Phone Email Post
Please pick the main 4 services your organisation provides*

Advice/counselling Environmental Issues Learning & Training Advice/ support Faith Rural Issues Arts Funding & Sustainability Social Enterprise Capacity Building General Community Activities Sports Children & Young People Health & Social Care Transport Crime & Community Safety Housing & Tenants Volunteering
What would you consider your primary service*
Please pick the main 4 client groups your organisation works with*

Adults Children & Young People (ALL) People with Mental Health Issues Animals Faith Groups People with Physical or Sensory Disability BME (Black Minority Ethnic) Groups Lesbian/Gay/Bisexual Transgender issues Carers Men Only Voluntary Groups Children (0-4) New Communities (e.g. EU Migrants) Volunteers Children (5-10) Older People (50+) Women Only Children (11-16) People with Learning Disability Young People (17-25) ALL
Who would you consider your primary client group?*
Please tick the district/ward(s) your group operates in*

Brighouse Luddendenfoot Skircoat Calder Valley Northowram & Shelf Sowerby Bridge Elland Ovenden Todmorden Greetland & Stainland Park Town Hipperholme & Lightcliffe Rastrick Warley Illingworth & Mixenden Ryburn ALL
National?

Yes No
Areas worked in outside Calderdale
The following section will NOT been seen on your public profile
What is your level of funding? (If you are not based in the Calderdale Council Area, please tick 'outside Calderdale')*

No funding Less than £5k £5 - £20k £20 - £150k £151 - £300k More than £300k Outside Calderdale
What is the structure of your group/organisation?*

Community Group or Club with a Constitution Community Group without a Constitution Social Enterprise Faith Group Self Help/Service/User Led Group
What is your legal status?*

Registered Charity Company Limited by Guarantee Community Interest Group (CIC) Statuatory Body Unincorporated
Charity No. (If applicable)
Company no. (if applicable)
Who funds your organisation?

Self raised - fundraising Big Lottery CMBC Capacity Builders Children in Need Commuity Foundation for Calderdale Children & Young People Health & Social Care NHS WY Partnership Church Urban Fund Comic Fund Large Trust Government dept.
How many Volunteers does your organisation have?
How many paid members of staff does your organisation have?*
Do you have any quality standards?

Investors in people Investors in Volunteers Youth Works Ofsted PQASSO Visible Compact
Any others, please specify
Rooms for hire?

Yes No
Number of available rooms for hire
Facilities

Wheelchair Access Hearing Loop Catering Refreshments Car Parking Disabled Car Parking Photocopying
Would you like to be included on the National Volunteering Database?

Yes No
Enter the message as it's shown*
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Voluntary Action Calderdale Database Form

VAC’s Database has been built and developed to collate a comprehensive record of organisations and contacts, mainly in Calderdale, but also in surrounding boroughs and nationally. These records may be used in 2 ways.

1. Basic information (service area, contact details and web address) CAN BE MADE AVAILABLE ON THE WORLD WIDE WEB for the general public to find out about your organisation and what it does.

2. The information provided will be used solely by VAC as part of their work providing services to voluntary organisations. The information will be used by VAC to send your organisation relevant information and for monitoring purposes only.

The following section will NOT been seen on your public profile