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Community access scheme
ENQUIRY FORM
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About You
Organisation name/community group name
(Required)
Your Address
Address Line 1
Address Line 2
City
Postcode
Your Email Address
(Required)
Email Address
Confirm Email Address
Your Phone
(Required)
Your organisation status
(Required)
Registered charity
Community interest company (CIC)
Community benefit society
An organisation that provides services directly to people who face barriers to visiting Compton Verney
Service provider to people with additional needs
Other
About your service users
Primary group type
(Required)
Carers service
Community centre/association
Community horticulture/environmental group
Debilitating illness support
Family and early years service
LGBTQ+ groups
Mental health services
Services for neurodiverse people
Services for older people
Servicers for persons living with Dementia
Services for women
Services for men
Services for young people
Services for disabled people
Services for people from ethnic minority backgrounds
Services for refugee, asylum seekers and migrant communities
Services for person who have sensory impairments or are deaf
Services for ex-offenders
Recovery programme
Does your organisation support any other group types?
(Required)
Yes
No
Please briefly describe your organisation, its purpose and the service users you would be bringing to Compton Verney.
(Required)
What ages are your service users?
0-4
5-11
12-15
16-24
25-34
35-44
45-65
65+
All
How many people access your service?
(Required)
Finance contact
Please complete if different to key contact. Go to the next section if the contact is the same
Finance contact name
Finance phone number
Finance email
How did you hear about this scheme?
(Required)
via staff or volunteer at Compton Verney
Word of mouth
Website
Social media
via other organisation
other
Would you like to receive the latest news and information by signing up our membership newsletter. (sent monthly via email)
(Required)
Yes
No
First name
(Required)
Last name
Your job title
(Required)
Your Comments/Questions
(Required)
Email
This field is for validation purposes and should be left unchanged.
