NEW GROUP
INFORMATION SHEET
GROUP DETAILS
Name of Group ......
Meeting Place Address ......
...... Postcode ......
First part of postal codes of the areas covered by your group, e.g. NW1 (not postcodes of
your Members): ......
Group Email Contact (we recommend that all groups set up a generic email address that all committee members have access to e.g ‘group name’@gmail.com) ......
Group contact phone number (can be the personal number of a committee member)………………………….
Website Address (if applicable) ......
The above contact email address and phone number will be used to promote the group on our external website. This will enable more people to access and join the group.
Please sign below to confirm you are happy for the information to appear on our website
Signature:………………………………
Print name:…………………………..
Date:…………………………………….
NAMES AND ADDRESSES (Please include postcode and email if known):
Diabetes UK take Data Protection very seriously. The personal data on this form is only being collected for the purpose of managing local groups. Telephone numbers will be disclosed relating to enquiries from the general public about groups.
SECRETARY
Full name ......
Address
...... Post code
Home phone Mobile phone
Email...... *Membership Number:
Free Membership (please tick) I am happy for Diabetes UK to email me
Signature ...... Date ......
CHAIR
Full name ......
Address
...... Post code
Home phone Mobile phone
Email...... *Membership Number:
Free Membership (please tick) I am happy for Diabetes UK to email me
Signature:...... Date: ......
TREASURER
Full name ......
Address
...... Post code
Home phone Mobile phone
Email...... *Membership Number:
Free Membership (please tick) I am happy for Diabetes UK to email me
Signature:...... Date: ......
OTHER COMMITTEE MEMBERS (If required)
1. Full name ......
Address
...... Post code
Home phone Mobile phone
Email...... I am happy for Diabetes UK to email me
Signature:...... Date: ......
2. Full name ......
Address
...... Post code
Home phone Mobile phone
Email...... I am happy for Diabetes UK to email me
Signature:...... Date: ......
MAIN CONTACT
All groups should have a main contact to whom Diabetes UK can send information. Please tick one of the boxes below to indicate who the main contact is:
Secretary Chair Other ______
SAFEGUARDING CONTACT
It is essential that each group has a safeguarding contact. This can be one of the contacts listed above or another person.
Full name ......
Address
...... Post code
Home phone Mobile phone
Email......
GROUP TOOLS
If you feel the following would be useful to help promote your group please tick:
We know where the Local Groups Online Portal, with resources to run a Local Group, is.
We would like a logo created for our Diabetes UK Group
We would like a letterhead created for our Diabetes UK Group
Once complete, please return this form to your regional contact.
If you do not know who your contact is, please email to find out.
Alternatively post your completed forms to:
Volunteer Development Team, Diabetes UK, Macleod House, 10 Parkway, NW1 7AA
*The Chair, Secretary and Treasurer of all groups must be members of Diabetes UK. Diabetes UK provides free membership to these officers on request (please tick box). If you wish to continue paying membership as a donation to Diabetes UK, please do so.