Good Neighbour Schemes for Boston Residents' Survey - English

Good Neighbour Schemes for Boston?

Dear Resident,

Good Neighbour Schemes can offer a range of services such as those indicated below that may be helpful to people living in the area. Please read the list and tick the boxes to show whether you might use these services and / or might be able to volunteer your time and help. You can tick boxes in both columns.

General Data Protection Regulation (GDPR) 2018

The information that we gather from this questionnaire will be used to inform the development of a Good Neighbour Scheme for the above named community. In accordance with the GDPR act, we have a legal duty to protect and retain any personal data collected from you.

By ticking the box below you are confirming that you have read the Privacy Notice that will inform you about how and why we hold your data.

If at any time in the future you wish to opt out of receiving information from us or you require a hard copy of the Privacy Notice, please contact us, you can telephone us on 01529 302466 or email: communities@lincsymca.co.uk

Question Title

* 1. I consent to YMCA holding my personal data.

Yes

Question Title

* 2. Good Neighbour Schemes can offer a range of services such as those indicated below that may be helpful to people living in the area. Please read the list and tick the boxes to show whether you might use these services and / or might be able to volunteer your time and help. You can tick boxes in both columns.

Possible services we could provide:

	I may need this myself	I may be able to help
Would you like a 'Buddy' to accompany you shopping	Would you like a 'Buddy' to accompany you shopping I may need this myself	Would you like a 'Buddy' to accompany you shopping I may be able to help
Occasional help with shopping	Occasional help with shopping I may need this myself	Occasional help with shopping I may be able to help
Befriending - a friendly chat by telephone	Befriending - a friendly chat by telephone I may need this myself	Befriending - a friendly chat by telephone I may be able to help
Prescription / medication collection	Prescription / medication collection I may need this myself	Prescription / medication collection I may be able to help
Help with form filling / letter writing / applications	Help with form filling / letter writing / applications I may need this myself	Help with form filling / letter writing / applications I may be able to help
Pet-care and dog walking	Pet-care and dog walking I may need this myself	Pet-care and dog walking I may be able to help
Help with digital services (TV, computer, phone etc), to include accessing Zoom / FaceTime	Help with digital services (TV, computer, phone etc), to include accessing Zoom / FaceTime I may need this myself	Help with digital services (TV, computer, phone etc), to include accessing Zoom / FaceTime I may be able to help
Help with small household tasks (eg changing a lightbulb)	Help with small household tasks (eg changing a lightbulb) I may need this myself	Help with small household tasks (eg changing a lightbulb) I may be able to help
Signposting to activities in the area	Signposting to activities in the area I may need this myself	Signposting to activities in the area I may be able to help
Food bank support	Food bank support I may need this myself	Food bank support I may be able to help

Any other services you would be interested in receiving? Please specify:

Question Title

* 3. Volunteering Opportunities: A Good Neighbour Scheme is volunteer led and supported by the YMCA Lincolnshire.

	I may be able to help
Would you like to be part of the organising group?	Would you like to be part of the organising group? I may be able to help

Question Title

* 4. Youth Opportunities: A Good Neighbour Scheme is for everyone; we would like to engage young people in Boston.

	Please tick:
Would you like to be part of the organising group?	Would you like to be part of the organising group? Please tick:
Do you need help?	Do you need help? Please tick:

Please comment further:

Question Title

* 5. Please provide your details, so that we can get in contact with you. If your organisation would like to get involved with the Scheme, please provide these details:

Name

Organisation name (if applicable):

Address

Address 2

City/Town

Post Code

Email Address

Phone Number

Thank you for completing the survey.
If you would like more information on Good Neighbour Schemes please visit:
https://communitylincs.com/projects/good-neighbours-schemes-helping-community/
or email: GNS@lincsymca.co.uk