| Please note that only the data in
the white boxes will be visible in your profile. Data requested
in green boxes is for administrative purposes only, eg contacting you
direct, or reporting to funders, and will not show on the website. Fields
which we need you to complete are marked *
. Your profile will only be visible to other members, not the general
public, and can be updated by you at any time by going to "Change my
Profile" from your profile page. |
| Constitution & Rules: I have
read and agree to the rules of this scheme which are displayed here |
* |
Referee:
Name of the person referring you to this scheme.
If your referee is not listed as one of our contacts, please add a phone
number and/or email address. If you do not have a referee, we will ask
a local co-ordinator to contact you). |
*
|
Trading Name:
This can be your own name in full, a shorter
version of your name, a nickname, or if this is an organisational
account, the organisation, project, or business name. Please note
that this is the name that will appear on your profile.
|
*
|
| Your Full Name, including title
if any |
* |
| Male / Female |
Female
Male
Other * |
| Year of Birth: yyyy |
* |
| House Number and Street Address |
* |
Neighbourhood/ Village
This is important. It represents "walking distance"
around where you live, and does not map precisely to postcodes or political
boundaries. If you are unsure about this, put your nearest tube or overground
station. |
* |
| Borough / Town |
* |
| City / County (in London put
"London") |
* |
| Postcode |
* |
Website if relevant:
NB if you want to cross-reference to websites in your
visible profile, please put them in your introductory statement below.
|
|
| |
| Email Address: This
will not necessarily show in the profile, but you will need it to take
part in the system. If you do not have an email address and a friend
is going to help you, ask them to set up an email address for you, even
if they are going to access the system on your behalf so that your email
messages do not get mixed up with theirs. |
* |
| First Contact Preference: |
* |
| Second Contact Preference: |
|
Employment Status:
This indicates your general availability to take part in the scheme
and is important for statistic purposes, so we know which sections of
the community we are reaching. Any explanatory details can be put as
a note in the next box. |
For multiple selection
-
Hold down <Ctrl> key in PC, or <Apple> key in Mac.
|
*
|
|
|
Special Needs:
Please mention here any access or mobility issues or other special needs
that you would like us to know about. Anything you wish to be shown
on your profile to other members, pleases also mention in the "About
Me" box below. |
|
| Usual means of transport: |
*
|
Smoker/ Non-smoker:
This is for matching people up to work together |
Smoker
Mild-smoker
Non-smoker *
|
Diet:
This is for matching people up to work together. |
Non-vegetarian
Vegetarian
Vegan *
|
Computer
Level of Ability:
Because this system is web-based we need to identify at the outset those
who will need, or can give technical support. |
Need Assistance
Need Tuition
Need Access
Can Manage
Willing to help others *
|
Usual Availability:
Please tick to show which times of day you are normally
available - you can update this at any time.
|
|
What is your Ethnic Group?
These categories are taken from the census, and may
be asked for by potential funders. Please choose ONE section from A
to E, then tick the appropriate box to indicate your cultural background.
|
*
|
Country of Origin:
|
*
|
Languages Spoken:
(eg, English, French, Polish, Hindi, Urdu, Bangla)
|
*
|
About me:
Please write up to 100 words as a general introduction.
Don't include "Offers", as there is another space in the profile where
you can put these. "Wants" are usually dealt with by emailing members
in the relevant directory category, but if there is something outstanding
or ongoing, do include it here. If you want to refer to your own or
a project website you can put it here prefaced by http:// and it will
work as a link in your profile. |
*
|
| |
|
Picture
of yourself.
We invite you to submit a picture of yourself suitable for your profile.
Click Browse and then choose the file from your computer.
|
Upload new picture:
|
| |
|
| Password: please enter a password
(if it is more than one word, put hyphens between) that you are unlikely
to forget - this can be altered at any time). |
Choose a password:
*
Re-enter password:
*
|
| Other Information: If there are
any other matters which you wish to draw to our attention, please write
them here. For example previous trading history in a LETS which has
folded. If you remember something after completing this application
please contact the administrator via the website www.letslink.org/london |
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