Essex Warm Bank / Warm Room Expression Of Interest - Winter 2022 / 23
PLEASE READ THIS INFORMATION CAREFULLY. YOU WILL BE REQUIRED TO ELECTRONICALLY SIGN THE DECLARATION AT THE END OF THIS FORM TO SHOW THAT YOU HAVE READ AND UNDERSTOOD EVERYTHING IN THIS SECTION.

THIS FORM IS FOR PEOPLE WHO WISH TO EXPRESS AN INTEREST IN PROVIDING A 'WARM BANK' OR 'WARM ROOM' SPACE OVER THE WINTER MONTHS OF 2022 / 23. THIS IS AN OPPORTUNITY TO LEAVE SOME BASIC DETAILS - MORE INFORMATION WILL BE PROVIDED TO YOU AS SOON AS POSSIBLE.

Essex Is United is a collaboration between Essex County Council, The Essex Public Health Team, the local NHS, and local Facebook groups.

IMPORTANT INFORMATION REGARDING THE USE OF YOUR PERSONAL INFORMATION

Any information submitted using this form will be stored by Essex County Council and only accessed by Essex County Council and those working on their behalf in accordance with their current GDPR and data protection policies. It may be shared with Provide, an organisation that works alongside Essex County Council, and other approved partners solely for the purposes of making sure that respondents are connected directly with members of their local community who are organising volunteering efforts.

For your information, you can read the relevant Essex County Council policies regarding data protection and GDPR at https://assets.ctfassets.net/knkzaf64jx5x/3ELBevLgnrxOqwr6i6EEME/95985ec440b441efcad32067836105f5/Privacy_notice_easy_read_guide.pdf

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Your Name *
Your Organisation / Group Name *
Your Organisation / Group Address *
Your Organisation / Group Postcode *
Your Organisation / Group Telephone Number *
Your Organisation / Group Opening Hours *
What You Could Offer Local Residents Who Want To Keep Warm *
Your Essex District *
Required
DECLARATION *
Please enter your full name below to confirm that you have read and understood the information at the top of this form. We strongly recommend taking a few moments to read it again before completing this box. PLEASE REMEMBER that any information submitted through this form will be shared with Essex County Council and key partners for this project.
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