Community Engagement Practitioner Programme (Pilot) 2015 Expression of Interest Contact Details Organisation or Group Name Your Name (you might not be the person who will ultimately attend the training) Your Job Role/Title Address Your Telephone Number Your Email Address Note: For your organisation or group to become an ‘engagement provider’ for the CCGs the staff member or volunteer must successfully complete all five sessions of the programme, becoming a registered Community Engagement Practitioner. Important: Attendees for each of the local training programmes will be selected based upon how relevant their organisation or group’s access to communities and geographical reach is to the specific engagement activity which CCGs wish to conduct at the time the training programme will be delivered. Please indicate which Community Engagement Practitioners Programme you wish the member of staff or volunteer to attend (please only choose one of the three programmes). 1. Airedale, Wharfedale and Craven CCG Programme to be held 9.30 am to 12.30 pm 1 Belle Vue Square, Broughton Road, Skipton, BD23 1FJ I wish for a member of staff or volunteer from my organisation or group to attend this programme and confirm they will be able to attend all of the sessions listed below (please tick Monday 14th September 2015 Monday 21st September 2015 Monday 28th September 2015 Monday 5th October 2015 Monday 12th October 2015 2. Bradford District CCG Programme to be held 9.30 am to 12.30 pm at the Thornbury Centre, 79 Leeds Old Road, Bradford, BD3 8JX I wish for a member of staff or volunteer from my organisation or group to attend this programme and confirm they will be able to attend all of the sessions listed below (please tick) Thursday 17th September 2015 Thursday 24th September 2015 Thursday 1st October 2015 Thursday 8th October 2015 Thursday 15th October 2015 3. Bradford City CCG to Programme to be held 9.30 am to 12.30 pm at Carlisle Business Centre, 60 Carlisle Road, Bradford, BD8 8BD on the following dates I wish for a member of staff or volunteer from my organisation or group to attend this programme and confirm they will be able to attend all of the sessions listed below (please tick) Wednesday 23rd September 2015 Wednesday 30th September 2015 Wednesday 7th October 2015 Wednesday 14th October 2015 Wednesday 21st October 2015 To be an ‘engagement provider’ your organisation or group must be able to meet the following criteria. Please tick to indicate that your organisation or group meets each of the criteria CRITERIA Be a constituted VCS organisation or group (have a constitution document and a governing body such as a Board of Trustees). If you are a registered charity, please provide your charity number below Charity Number Have all of the following policies in place • • • • • Health and Safety Equality and Diversity Safeguarding Vulnerable Adults and Children Volunteering Complaints procedure Please tick to confirm • Grievance and Disciplinary procedure Have both of the following insurances in place • • Public Liability Employers Liability Please complete the profile below outlining the potential reach of your organisation or group in terms of the people you work with Where are you based – which CCG area(s) or ward (s)? What geographical area does your group or organisation cover – which post codes and local authority ward areas? Who do you engage with as part of your work – please list specific protected characteristic or seldom heard groups, if any? Can you reach/target any additional audiences not part of your core audience above, if so who and how? Does your organisation or group have any special health or social care interests, for example people who are carers, people with diabetes, mental health etc. In conducting engagement work, what approaches is your organisation or group most likely to want to use? Please tick all approaches your organisation or group would use. Surveys Focus groups Drop in session Interview Other (please list any other approaches your organisation would use) Do you have any particular requirements or other ideas regarding engaging people who use your service or attend your activities? Is there anything else which should be considered when engaging people who use your service or attend your activities? Please return your completed Expression of Interest to rebecca@healthpartnership.org.uk no later than 5 pm on Thursday 23rd July 2015. All Expressions of Interest received by the deadline will be acknowledged by email. An offer of a place on the Community Engagement Practitioners Programme will be made to successful applicants no later than 5 pm on Friday 7th August 2015. If your organisation or group is accepted on to the programme you will then be asked to complete a very short online booking form giving details of the member of staff or volunteer that will be attending the programme.