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Host Ukrainian Refugees Lincolnshire Network
HURLNET
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Offer of Assistance form – Administrator/Regional Coordinator
Indicates required field
Full Name
Contact Number
Email Address
Preferred Contact Method
Phone
Email
Nearest Town/City
District
i.e. NKDC
Postcode
Assistance Offer
Administrator
To assist in publicity, collating data, managing regional coordinators.
Regional Coordinator
Ensure distribution of services to end user requests.
Number of hours offered per week?
Do you have your own IT equipment?
Yes
No
Would you be prepared to use your own telephone?
Yes
No
What days are you available?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
GDPR
None of your information will be passed on to anyone other than the partners that we work with to enable the network to place refugee families with willing hosts.
Are you happy for us to share your information?
Yes
No
Information message
Please bear in mind that this is an initial drive to establish a host network. Should circumstances change and the network is no longer required your data will be destroyed within 3 months of the closure of the network.
Signature of Donor
Please sign above
Date
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