community action reporting form

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If you have an issue in the community that you would like the Hangleton & Knoll Community Action Group to look at please fill this in and return it to St Richards.

TRANSCRIPT

Page 1: Community Action Reporting Form

Hangleton and Knoll Community Action Report Form

Date Name Contact Details

Tel No.______________________E-mail Address_____________________

Community Group/Activity

Report Code

Description

(PLEASE CONTINUE ON OTHER SIDE IF NEEDED)

I would/would not like to be contacted with regard to the information I have given above. My preferred method of contact is:……………………………………………

I would/would not like to receive minutes of Community Action Meetings

Hangleton and Knoll Community Action will treat all information given above in accordance with the Data Protection Act 1998 and only use this information for the purpose intended. No personal information about you or any other individual will be revealed at meetings.

This section to be completed optionally

Age Gender Ethnicity

COMMUNITY ACTION……YOUR PLACE, YOUR VOICE, YOUR SOLUTION

Community Action Wednesdays 10.30am-12noon

at St. Richards Community Centre, Egmont Road

Please call Community Development Workers on 410858 or 821380 for

more information

Page 2: Community Action Reporting Form

Cover NoteThis form is for use by community groups and local residents who are unable to attend Community Action meetings, so they may feedback any issues/concerns regarding the following: 1. Community Safety

2. Housing

3. Environment

4. Health

5. Training and Learning

6. Employment

7. Older people

8. Young People

9. Other

What to do with your completed form Complete the form with as much information about the issue(s) as possible Please add the code(s) from the list above that best describe(s) your issue to the

‘Report Code’ column on the form e.g. for an issue regarding Housing, you would add ‘code 2’

Once completed, please hand your form to a member of Hangleton & Knoll Project staff/local service provider/a staff member at a community centre/community building

If you are submitting your form electronically, please email it to Lulu, Hangleton & Knoll Project Administrator: [email protected]

Your issue will then be raised and addressed at the next Community Action Meeting If you have requested feedback regarding your issue, your form will be passed to

the community representative/service provider dealing with/actioning it, who will contact you regarding progress with the matter

________________________________________________________________

PLEASE NOTE: If you are using this form to report Anti-Social Behaviour please also contact Sussex Police on 0845 6070 999 or the Anti-Social Behaviour Team at Brighton

and Hove City Council on 292929