Thank you for volunteering to complete this information form to help us build a strong team of local people to serve the Monmouthshire Community.

Keep safe and remember to follow the latest Government guidelines at all times. We will get through this!

Please share Our Monmouthshire with your friends, colleagues and family using this link: ourmonmouthshire.org

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* 1. What is your full name?

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* 2. What is your email address? 
(This will only be used to send you your Street Coordinator Welcome Pack)

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* 3. What do you normally do?
(This could be your usual job or role you have)

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* 4. Do you hold a paid or voluntary role that requires a valid DBS and references?

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* 5. If 'Yes', please tell us what your role is and/or what your DBS certification number is.
(For example; School Teaching Assistant, Brownie Leader, Playgroup worker, Care Worker)

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* 6. Which local community could you help?
(This could be your home town or village, or where you work or volunteer)

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* 7. Do you have any of the following skills and assets?

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* 8. Do you have a good understanding of (and connection to) the assets and people within your local community?
(Street coordinators are well-connected people, placed to pull organisations and groups together to work collectively)

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* 9. Do you have any neighbours, other local residents, friends or colleagues who could help you?
(Street coordinators manage a group of up to 6 helpers; this is easier if you already know them!)

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* 10. If 'Yes', would you be willing to act as their Street coordinator?

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