Interlink Membership Application Form

Interlink Membership Application Form Who are we? Interlink RCT is about supporting you to make a difference in your community whether you are an individual, group or organization. We are a charity working with over 500 members in RCT from small community groups to larger charities. We can help you:  Get more funding  Work with other people, communities or  Recruit and support volunteers organisations  Plan and run a project  Influence people and decisions that affect you  Get expert help and advice  Have training provided for you and your group  Develop and grow your group  We can help you promote what you do to others. We are here to help YOU get the help and support you need Organisation: Main Telephone No: Organisation Contacts: Name e-mail Mobile No 1 2 3 4 Address:

Website: 1. What geographical area(s) do you cover? Cynon RCT National (UK)

Rhondda RCT & Merthyr National (Wales)

Taff Ely Other (please specify below)

______Aim / Main purpose of your organisation: (two or three sentences)

Who do you work with? e.g. children, adults with mental health issues, families, etc

Please describe your organisation in one or two sentences – this would be used to describe your organisation (on a website for example).

What services do you provide? Please tick all that apply: Health & Social Care Arts, Culture and Employability Chronic Conditions Heritage Volunteering Drawing/Painting/Sculpture Community/Social Care Jobs Music Weight Management Confidence Building Dance Substance Misuse Building and Carpentry Photography Mental Health Training/Qualifications Media/Journalism Sexual Health Employment (cv/workclubs)

Last amended on 12/05/2015 by KP Befriending/Peer Support Library/Books NEETS

Older People Museum Work Placements

Healthy Eating/Cooking Film Environmental Work

Carers Theatre/Drama

Outdoor Activities Singing/Choir

Visitor Centre/Attraction

Heritage Conservation

Community Development Children,Young People Environment and Regeneration and Families Community/Social Enterprise Youth Work Reduce, Reuse, Recycle

Community Building/Centre Early Years Environmental Conservation

Volunteering Family Support Food

Community Work/Development Childcare Biodiversity

Community Learning Education Sustainability

Regeneration Disability Energy Conservation/

Risky Behaviour Generation Information and Advice Involving People and Sports and Leisure Equalities Financial Advice BME Outdoor Activities/Walking

Legal Advice Older People Sport

Benefits Advice Disability

Debt Advice Women Transport Community Transport

Are there any criteria for accessing your organisation? (e.g. people must be over 18 and living in Tonypandy)

How many people do you involve and use your services per month? How many Committee members have you got? How many volunteers do you have in total? How many hours on average do they give per month? Please tell us if you would you like any advice, support or training?

Please confirm you agree that this information can be shared with others to tell them about what you do? Signed: Date:

Last amended on 12/05/2015 by KP Data Protection Act 1998.

The details above will be held and processed by Interlink electronically and the forms will be kept manually. The information will be used to inform individuals, communities and organisations about what you do and shared with partners, such as local authorities and health boards.

Last amended on 12/05/2015 by KP