FFN- Programme 2019 Partner Organisation Questionnaire

Family First Nights Partner Organisation Questionnaire
Main Contact*

First NameLast Name
Secondary Contact*

First NameLast Name
Job Title/s / Department/s*
Organisation:*
Address*

Street Address

Street Address Line 2

CityBorough

Post Code
Contact No. / Mobile*

Area CodePhone Number
Email (Please be aware that EMAIL is our main form of contact)*
Are you a Supplementary School?*

YesNo
Please tick if you are happy to be listed for families who enquire about suitable FFN referral contacts in their borough. Contact name, organisation, number, email, listed above will be published on our website. *

YesNo
If yes, please give a brief description of your organisation and the services you provide,which will also be listed:
Services you provide (please tick any that apply):*

Leisure ActivitiesInformation, advice and guidanceDrop-in centreCase workTrainingBenefits adviceFinancial SupportSocial EventsOther
Would you describe your organisation as (please tick any that apply):*

VoluntaryCommunityStatutoryUser-ledFront-lineLocal department of a national charitySecond-Tier
Are your services particularly geared towards:*

Children / Young people?Relative carers / foster carers?Parents?Type option 4Other
How many families does your organisation work with?*
How many paid members of staff work in your organisation?*
How many volunteers work in your organisation?*
Will you need to help families fill in the application form?*

YesNo
If families you work with take part, will you consider subsidising their tickets?*

YesNo
How easy is it for you to identify suitable families to take part?*

Very easyNeither easy nor difficultFairly difficultVery difficult
Any other comments:
Due to new law we need to confirm that:

IF YOU SELECT NO TO BOTH OF THESE QUESTIONS BELOW, YOU WILL NO LONGER HEAR FROM US BY EMAIL
You are happy to receive communication from us regarding Family First Nights*

YESNO
You are happy to receive emails from us (approx. once a year) about other Mousetrap opportunities, events, areas of support, e.g. ways you can help Mousetrap like casting your vote for us to win an award*

YESNO
Terms and conditions (please tick):*

We will ensure that the offers will only be distributed to appropriate familiesWe confirm that no paid workers of this organisation will take up any of these offersWe agree to take responsibility of distributing the FFN leaflets to the relevant low-income families and make sure families receive them in time to participate in the programmeThere must be a designated contact person for the duration of the summer programme (June – August). If the named contacts are away, please ensure there are members of staff who know how the programme works and can deal with any queries in their absence.
Should be Empty:

Family First Nights Partner Organisation Questionnaire