KCVS : Sign Up

Housing & Environment

Children & Young People

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Membership Form

Only fields marked with an asterix are required for registration, but filling out the rest of the form will help us cater for you better.

Individual Details:

Step 1

Please provide your personal details.

Title
First name*
Last name*
Ethnic Origin
-- Or --
Other ethnic group
Gender

Postal Address:

Step 2

So we can contact you by post please provide your address.
Preferred Contact Method
e-Mail*
House/Flat Number
Street
Town/City
County
Post Code
Telephone (work)
Telephone (home)
Mobile no
Fax no

Login details:

Step 3

You need to think up a username and password for yourself. This will enable you to access further areas on our web site (password can be changed later). Your username must be at least 6 characters long with no spaces.

Username*
Password*
Re-type*

Special Requirements:

Step 4

Special Requirements	Braille Large Print Minicom Induction Loop
Other language (inc. Sign)
Any other requirements

Categories:

Step 5

Choose the areas you are interested in from the list below.


Advice, Support & Information	Select all
Alcohol/ Drug/ Substance Misuse	Benefit/ Debt/ Welfare Rights / Small grants
Citizen' Advice	Counselling
Funding Advice	General Advice
Offenders/ Ex Offenders	Translation Services
Victims of Crime/ Domestic Violence	Volunteer Support
Volunteering	Witness Support

Community	Select all
Community Development	Community Centres / Village hall
Community Facilities	Council For Voluntary Service
Crime and Safety	Faith groups & places of worship
Media	Parish Council
Support for voluntary & community groups	Support for Young People

Health & Social Care	Select all
Caring	Bereavement Care & Counselling
Hospice / Care Homes	Mental Health
Mother and baby	Parent support
Physical health	Respite Care
Sensory & communication	Agriculture & Food
Charity Shops	Economy & Employment
Employment	Parish Planning
Regeneration	Village shops & other Rural retail

Learning, Work & Training	Select all
Education (children over 16 years of age)	Adult education
Basic Skills	Early Years Education
Education years 1-12	Information Advice & Guidance
Learning Disability	Other training
Return to work support	Training - IT

Arts, Entertainment, Leisure and Sports	Select all
Creative Arts	Dance
Music & Choral	Parks & Open Spaces
Social Clubs	Sports & Physical Activities
Theatre
Children & Young People	Select all
Child Care	Play
Youth Clubs
Housing	Select all
Tenants & Residents Associations	Homelessness
Rural Housing	Sheltered Housing

Environment / Transport	Select all
Heritage	Community Transport
Conservation	Environment
Local History & Heritage	Town Twinning
Volunteer Driver / Cars
Beneficiaries	Select all
Children 0-4	Animals
Benefits Advice	Black and Minority Ethnic Groups
Carers	Children 5-7
Children 8-13	Community
Conselling Services	Environment
Ex Offenders/Offenders	Faith
Families	Homeless People
Lesbian/Gay Men	Lone Parents
Men	Migrant Workers
Parents	People 26-49
People 50-79	People in Residential Care
People Isolated by Location	People over 80
People with HIV/AIDS	People with Learning Difficulties
People with Mental Ill Health	People with Physical Disabilities
Refugees/Asylum Seekers	Residents
Service/Ex-Service	Substance Misusers
Tenants	Transgender/Transsexual
Unemployed/Low Income	Victims of Abuse
Voluntary Organisations	Volunteers
Women	Young People 14-19
Young People 20-25
Animals	Select all
Animal Rescue	Animal Clubs & Societies

Older People	Select all
Luncheon Clubs	Advocacy & general support
Friendship Clubs	Good Neighbours Scheme
Health
Geographical Areas (By Ward)	Select all
Shevington	Cherryfield
Halewood North	Halewood South
Halewood West	Kirkby Central
Longview	Northwood
Page Moss	Park
Prescot East	Prescot West
Roby	St Bartholomews
St Gabriels	St Michaels
Stockbridge	Swanside
Whiston North	Whiston South
Whitefield
Group Facilities	Select all
Braille	Accessible Toilets
Disabled Access	Disabled Parking
Induction Loops	Large Print Information
Minicom	Sign Language Service

Join:

Step 6

I accept the

Only click this button ONCE --><--Only click this button ONCE

By clicking on the 'Sign Me Up' button you are agreeing to our Terms & Conditions.

Some documents on this site are available to download using Adobe Acrobat^® Reader.
If you do not have Reader on your computer you can download it free by clicking on the icon below

click on the logo below to visit the Knowlsey CVS website

click on the logo below to visit the Community Empowerment Network website

Some documents on this site are available to download using Adobe Acrobat® Reader.If you do not have Reader on your computer you can download it free by clicking on the icon below

click on the logo below to visit the Knowlsey CVS website

click on the logo below to visit the Community Empowerment Network website

Some documents on this site are available to download using Adobe Acrobat^® Reader.
If you do not have Reader on your computer you can download it free by clicking on the icon below