PLEASE READ THIS INFORMATION CAREFULLY.  YOU WILL BE REQUIRED TO ELECTRONICALLY SIGN THE DECLARATION AT THE END OF THIS FORM TO SHOW THAT YOU HAVE READ AND UNDERSTOOD EVERYTHING IN THIS SECTION.

WE HAVE DESIGNED THIS FORM TO COVER AS MANY DIFFERENT BUSINESSES AS POSSIBLE.  THEREFORE, NOT ALL THE QUESTIONS MAY BE APPLICABLE, AND ANYTHING THAT ISN'T MARKED WITH A STAR / ASTERISK (*) IS OPTIONAL.

This form is for any business owner/operator who wants to volunteer and help in their local community with vulnerable or self-isolating people during the Coronavirus / Covid-19 outbreak.  We are looking not only for volunteers in person, but of goods, services or logistics that may be available. 

Thurrock Coronavirus Community Action is a collaboration between Thurrock Council, Stronger together and Thurrock CVS along with Thurrock organisations, the voluntary sector and local Facebook groups to ensure that support assistance reaches the people who need it the most. 

Once you have submitted this form, a member of the Stronger Together Thurrock team will be in touch at the earliest possible opportunity.  Please bear in mind that there may be a small delay due to the volume of people contacting us.


Any information submitted using this form will be stored and accessed only by those working on the Thurrock Coronavirus Community Action project and will be done so following current GDPR and data protection policies.  It may be shared to approved partners solely for the purposes that respondents are connected directly with members of the local community who are organising volunteering efforts.

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* 1. Email Address

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* 2. Telephone Number

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* 3. You and your business

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* 4. Nature of your business

Please enter the main activity carried out by your business

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* 5. The area covered by your business?

Please enter the area covered by your business.  Please be as specific as possible.

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* 6. Tasks your business are willing to help with?

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* 7. Hours of operation

If your business has hours of operation, please enter there here.

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* 8. Existing skills of your business or employees?

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* 9. Number of staff / volunteers?

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* 10. Is there anything you think your business could provide or support with?

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* 11. Thurrock Coronavirus Community Action page on Facebook

Have you "liked" the  Thurrock Coronavirus Community Action page on Facebook?  This is the easiest way to keep up to date with the latest information, news and announcements about Covid-19 and volunteering in Thurrock.

DECLARATION

Please enter your full name below to confirm that you have read and understood the information at the top of this form.  We strongly recommend taking a few moments to read it again before completing this box.  PLEASE REMEMBER that any information submitted through this form will be shared with Stronger Together Thurrock Covid-19 and key partners for this project.

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* 12. Name

0 of 12 answered
 

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