1. Contact Information
Name of Organisation(*)
Please type your full name.
Address
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City
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Post Code
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Telephone
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Contact person for membership
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Job title
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Email(*)
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1.a. Key Contacts - type them in here OR upload a list
Directors/ CEOs/ Managers of your organisation who SSPA can keep informed
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Directors/ CEOs/ Managers of your organisation who SSPA can keep informed
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Other colleagues' emails to go on our e-newsletter mailing list
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Alternatively upload a list of contacts
.xlsx/ .docx/ .pdf can be uploaded
2. Legal Information
Charities registration number(*)
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Level of approval(*)
Required area
Please provide evidence of contract: either(*)
Required area
Upload your document(*)
Please complete
PDF file only
Contract year end
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3. Service Information
MSD Agreements:
List your contracted services or programmes
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Non-MSD Contracts:
List any contracted services or programmes
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4.Operational Information
Years of operation
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Geographic Reach
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Annual Budget and Funders: MSD
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Annual Budget and Funders: MOJ
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Annual Budget and Funders: DHB
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Annual Budget and Funders: Other
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Any cultural or ethnic focus?





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Number of staff
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Staff total FTE (full-time equivalent)
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Number of volunteers
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5. Membership Options (GST inclusive):
Please choose one of the following options.
Organisation’s Annual Budget in Total(*)
Required area
(*)
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