Suffolk User Forum individual Membership

Contact Information

First Name *

Last Name *

Street Address *

Address Line 2

City *

County

Post Code *

How would you like to be contacted? (Select all that apply) *EmailPhonePost

Email *

Landline Telephone number *

Mobile number *

Would you like to be a voting member or a non-voting member? *Voting memberNon-voting memberAs a voting member you have one vote at the SUF AGM. All Voting Members have a maximum liability of £10 If the charity is dissolved.

My SUF Membership

Question 1: Please let us know what areas of mental health and wellbeing you are interested in *I want to use my lived experience to influence decision making, service change and improvement to services.I have/had personal experience of mental illnessA family member or friend has/had personal experience of mental illnessI am a family/parent carer for someone with a mental health illnessI work in the mental health / wellbeing sectorI am interested in mental health / wellbeingI am interested in peer mental health advocacy

Any other areas not mentioned (please state below)

Question 3: I would like to be involved with SUF by *Giving my feedback on mental health / wellbeing servicesTaking part in surveys and research opportunitiesSupporting mental health user led coproductionAttending SUF’s coproduction groups (including Stepping Forward)Volunteering in SUFBeing more active and representing SUF at meetings and forumsBecoming more active and being involved in engagement work with other service usersI am interested in becoming a SUF TrusteeFundraising for SUF

Equality and diversity monitoring

The following questions are optional. We want to make sure that we treat everyone fairly in line with our equality and diversity policy. To do this we ask people to tell us about themselves. This information helps us build an accurate picture of our membership and supporters. You do not need to answer the following questions, but you will help us if you do. The information that you provide will be held anonymously and will only be used to provide statistical data. For more information, please read our privacy policy. If you wish to have your information deleted from our secure records please call us on 01473 907087 or email us at hello@suffolkuserforum.co.uk.

Date of birth

Day

Month

Year

Please select one of the boxes below which most appropriately describes your ethnic group or origin:Asian or Asian British (Includes and Asian background, Chinese, Indian, Pakistani)Black, African, Black British or Caribbean (Includes any Black background)Mixed or multiple ethnic groups (Inlcudes any Mixed background)White (Includes any White background)Any other ethnic group (Includes any other ethnic group, e.g. Arab)Prefer not to say

Black, African, Black British or CaribbeanAfricanCaribbeanAnother Black backgroundPrefer not to say

Mixed or multiple ethnic groupsAsian and WhiteBlack African and WhiteAnother Mixed backgroundPrefer not to say

Any other ethnic groupArabAnother ethnic backgroundPrefer not to say

What is your preferred gender?

What do you prefer to identify as?

Do you consider yourself to have a disability?YesNoPrefer not to say

Please specify

Privacy policy and consent

Suffolk User Forum (SUF)- Privacy NoticeSUF is the data controller of your information under the General Data Protection Regulations (GDPR). We take your privacy very seriously and your personal information will only be used to contact you as stated by your preferences. It will be kept during your membership with SUF. You can withdraw your consent at any time by calling SUF on 01473 907087 or by emailing us at hello@suffolkuserforum.co.uk Please read our Privacy Policy for more information.

Confirmation of consent *I agree to the Suffolk User Forum privacy policy.

Individual

Charity Information

Navigate

Where to find us

Contact us

Contact Information

Footer

Charity Information

Navigate

Where to find us

Contact us