Interim membership form
This form is to support those wishing to join in Chilli Studios Creative activities during the Covid19 crisis.
Future membership of the service, following the removal of restrictions, will require a new form to be filled in. There is no charge attached to our current service but some activity may be restricted.
Our current offer includes:
- Access to our Online forum community and activity
- Access to 3-7 live interactive workshops a week and basic technical support
Occasional & optional:
- check-ins and signposting
- postal art
Chilli Studios is a registered charity that delivers services to those who are, or are at risk of experiencing diagnosed mental health problems. Our Aim is: Improving mental health through Creativity. Our mission is “to provide a sustainable service that engages people in creative activity, which promotes social inclusion and interaction, develops skills and ability which builds resilience, enables potential and improves wellbeing.”
The General Data Protection Regulation (GDPR) came into effect on 25 May 2018 and we want to ensure that your data is handled correctly. Your details will be kept safely and confidentially and used by Chilli Studios only for membership, staff and our charity activity purposes only.
Address including postcode
Contact tel/mobile number
Date of birth
Preferred gender identity:
How would you describe your mental health needs
Issues with depression
Wellbeing affected by physical health
Autism and or Aspergers
Emergency contact - name, relation to you and their best contact number
Referral agent details (Name, title, address and contact details) Chilli Studios will accept a wide range of health-related referrals agents. If you do not have a referral agent do you receive support or attend activity with another organisation/charity?
What are your artistic interests and why?
How did you hear about our Charity activity?
What tech do you have at home? Our current activity is mainly online and knowing this will help us connect you further.
computer, laptop or notebook
somewhere close I can download from wifi e.g library, supermarket
mobile text only
Have you any comments or queries?
GDPR compliance requires that you tick this box to give the charity permission to contact and hold your information for utilizing and engaging with our service. Your information will be kept secure and safe and only to be used by Chilli Studios.
Thank you. We will get back to you soon. Take care and stay safe :)
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