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Name of Organisation
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Acronym (if applicable)
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Contact Details for Public Use
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Postal Address
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Post Code
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Phone
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Fax
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Minicom
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Email
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Website
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Name of Main Contact Person
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Position in Organisation
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Confidential Contact Details for Database Administration Use Only
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Postal Address
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Post Code
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Phone
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Fax
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Minicom
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Email
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Website
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Name of Main Contact Person
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Position in Organisation
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Meeting or Opening Hours
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Notes
Use this section to tell people about what your organisation does, who it's for,
services you provide and any other useful information. Please use no more than 200 words.
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Keywords
Keywords are used to search for particular Organisations, for example, all those who work with Children.
Please check any General Keywords, Services Offered or Type of Organisation
which you would like included to describe your organisation and to help in searching the database.
Check as many Keywords as you wish.
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General Keywords
Please check all that apply:
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Animal Welfare/
Animals/Birds
Armed Services
Bereavement
Carers
Children
Arts/Community
Arts
Community Based
Community Care
Community Work
Crime/Crime
Prevention
Education/
Training
Employment/
Unemployment
Environment/
Conservation
Faith/Religious
Families
Fund Raising
Gay/Lesbian/Bisexual
Grant Making
Health - General
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History
Housing/
Homelessness
Learning
Disabilities
Lone Parents
Mental Health
Minority Communities/
Ethnic Minorities
Offenders
Older People
Overseas Work
Physical and
Sensory Disability
Poverty
Recreation
and Leisure
Refugees and
Asylum Seekers
Sport
Substance Abuse
Transport Issues
Women/Girls
Young People
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Services Offered
Please check all that apply:
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Accommodation
Advice/Information
Advocacy
Befriending
Campaigning
Counselling
Day Care
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Drop In
Mediation
Respite Care
Spiritual Guidance
Support
Transport Service
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Type of Organisation
Please check all that apply:
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Civic Society
Club/Society
Commercial Organisation
Community Association
Community Centre
Day Centre
Faith/Religious Organisation
Family Centre
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Friendly Society
Housing Association
Political Party
Professional Association
Registered Charity
Statutory Sector
Tenants/Residents Assoc.
Voluntary Organisation
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Next, please choose one of the keywords which you have ticked above to act as a Primary Keyword and
enter this in the space below. If there are any keywords not included in the lists that you would like
to use to describe your organisation please enter these under Other Keywords.
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Primary Keyword
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Other Keywords
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Faith/Religious Organisations
If you have described yourself as a 'Faith/Religious Organisation', please let us know to which
religion/faith you adhere:
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Baha'i
Buddhist
Christian
Hindu
Jain
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Jewish
Muslim
Pagan
Sikh
Multi-Faith/Inter-Faith
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Other - please specify:
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Language(s) typically spoken
Please let us know which of the following languages are typically spoken within your organisation:
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Arabic
Bengali/Sylheti
Cantonese/Hakka
English
Farsi
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French
Hindi
Kurdish
Mandarin
Punjabi
Urdu
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Other - please specify:
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Access Information
Use this section to give us details about your building. This is useful information
for people with physical or sensory disabilities. If your office/meeting place/venue
is different from the contact address you have given, then answer these questions for
the office/meeting place/venue.
Check here if your building will never be used or visited by members of the public.
If your building is used by the public, please
answer the questions below. If not, please go on to the Miscellaneous Information section.
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Service Area
Please tick the areas and / or postcodes in which your organisation provides services. If your organisation
provides services across Leeds please tick 'City-wide'.
You may also choose West Yorkshire, Yorkshire and / or Nationwide if necessary.
NB if you do not tick any of these options your organisation will be entered as 'City-wide' for search purposes.
If you wish to be more specific, please put any further information in the 'Notes' section above.
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Miscellaneous Information
Please complete if applicable.
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Is your organisation ethnic-minority led?
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Yes No
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Is your organisation user led?
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Yes No
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Is your organisation disabled led?
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Yes No
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Do you recruit volunteers?
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Yes No
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Do you have rooms for hire?
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Yes No
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How many paid workers does your organisation have?
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What is your organisation's annual turnover?
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Under £1000
£1,000-£10,000
£10,000-£100,000
£100,000-£250,000
Over £250,000
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Declaration
The Data Protection Act states that we must have your consent before we can make the information you have
supplied available to the public. By submitting your details to us you thereby indicate that :
1. You agree that this information can be included in the database of Voluntary, Community and Faith
Organisations in Leeds, which is made available on the Internet and which may also be published in the form
of a paper based directory, as a resource for people wanting information about voluntary and community
organisations in Leeds.
2. You understand that the paper based directory may be made available for sale on a not-for-profit basis.
The database, however, will not be sold.
3. You agree that the information may also be included in the databases and publications of other Leeds City
Council departments and in the databases and publications of carefully selected partners of Leeds City Council
and/or partners of Voluntary Action-Leeds.
4. You understand that, since the database of Voluntary, Community and Faith Organisations in Leeds is freely
available on the Internet, this information can be viewed by anyone, anywhere in the world, who has access
to a computer which is connected to the Internet.
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Name
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Position in organisation
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Date
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