Cody Dock Web-to-Lead Form
Page 1
Personal Information
By completing this form, you are confirming that you are happy for Gasworks Dock Partnership to hold and use your details in line with ou
r
Data Protection Policy
.
You can opt out of this agreement at any time by
contacting us
.
Please provide as many details as possible.
Title
Please select...
Miss
Mrs
Mr
Ms
Dr
Other
Last Name
First Name
Email Address
Organisation Name - if not applicable please enter N/A )
Address Street
Address City
Address County / Borough
Address Postcode
Personal Email (if different from above)
Work phone
Personal Phone
By completing this form, you are confirming that you are happy for Gasworks Dock Partnership to hold and use your details in line with our Data Protection Policy [link]. You can opt out of this agreement at any time by contacting us [link].
How did you hear about us?
Please select...
Website
Facebook
Twitter
Instagram
News Article
Word of Mouth
Events
Other
Do you wish to go on our mailing lists and receive targeted updates from us? (you will only receive information on the interests you highlight below)
Please select...
Yes
No
Do you wish to receive our quarterly newsletter?
Yes
Preferred Contact
Please select...
Email
Text
Conventional Mail
Interested in hearing about things we do regards?:
Education
Arts
Heritage
Environment
Community Boat
Areas of interest
Which of the following relationships do you want to develop with Cody Dock?
Supporter
Volunteer
Funder/Donor
Service Provider
Service User
Partner
Volunteer questions
What are your Volunteering Interests?
Citizen Science and Environmental Conservation
Dock Restoration
Gardening
Events
Construction and Site Maintenance
Maintenance
Education
Professional Support
Community Boat Service (ie, Boat Handling)
Community Boat Restoration
Waterways
Environment
Heritage
Trustee
Citizen Science & Group Activities
Canoe based activities
Community litter picks
Tree planting
Professional Support further details
Max 500 characters
Are you willing to volunteer....
Yourself (as an Individual)
An Organisation
Both of the above
Are you enquiring about Group Volunteering events?
Yes
No
If so, how many?
Volunteering scheme
Max 500 characters
Volunteering website link
Volunteer Abilities - What could you do for us?
Professional Skills and Services
Unskilled Labour
Volunteer Availability - When could you do it?
Weekdays
Weekends
Morning
Afternoon
Weekly
Funder / Donor questions
What Type of Funding do you wish to offer us? (unrestricted - funding that we can choose where it is spent, restricted - funding that you stipulate what it should be spent on)
Unrestricted
Restricted
What are you thinking of Funding?
Partner Questions
Summary of how you hope to contribute to our mission and aims
Max 1,000 characters
Service User Questions
Services Interested in using (only 1 option)
Please select...
Corporate Volunteering
Team Building
Location Shooting
Private Hire
Studio Hire
Café/Bar
Education
Training
Mooring
Service User Questions
Summary of how you hope to contribute to our mission and aims
Max 1,000 characters
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Contact Information