Directory of Organisations

Organisation Details

Do you want your profile details adding to the NBN website?*
YesNo

The information you provide in the following section is mandatory for our purposes, but will of course only appear on our website if you have selected "Yes" to the above question.

Please be aware, if you do choose to appear on the directory but do not answer the section below it will appear blank on your profile on our website directory so please fill out as much as you can.

The contact details you have provided at the top of the form will not be shown on the website. We will facilitate the referral and connections once someone has selected a Support Broker from our online Support Broker directory.

Organisation Name:*

Organisation Logo:*
Maximum file size is 2MB. Photo must be at least 800px by 800px.

Address:*

Contact Telephone Number:*

Contact Email:*

Website:*

Social Media Links:
Facebook:
Twitter:
LinkedIn:
Instagram:

Have we worked together?:
YesNo

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NBN Consent Form

As a Member of Imagineer/Support Brokerage Network, it is important we ask you about your contact preferences and what information you want to receive.

We need to ensure that you are happy with us keeping your details so that we can contact you with information about our activities and find out about what we are doing.

To help Imagineer/Support Brokerage Network meet the data protection regulations we need to find out if you are happy for us to store your data – in accordance with GDPR.

Please complete your details and contact preferences below.

Date Completed*
Please type the relevant date in the format of dd/mm/yyyy

How would you prefer to be contacted? (You choose can more than one)*
EmailPostSMS Text MessageTelephone LandlineTelephone Mobile

I want to:*
Receive Imagineer's/Support Brokerage Network - News and UpdatesReceive Information about Imagineer's/Support Brokerage Network events that I attendReceive information about additional Imagineer's/Support Brokerage Network events

Subscribe to our mailing list?
yesno

Consent: (please tick if you agree)*
I confirm that I consent to Imagineer Development UK CIC and the Support Brokerage Network subcommittee keeping my information stored for the purposes of fulfilling their commitment to me as one of their members
I am aware that I can retract this consent at anytime and I can do this by contacting Imagineer Development UK CIC by phone, email or letter to retract this consent. At which stage any information stored about be will be deleted and / or destroyed appropriately

To Opt Out In Future:

You can opt-out of receiving information from Imagineer at any time by writing to or emailing Imagineer via email: info@imagineer.org.uk / Post: Imagineer Development UK CIC, Sowerby Bridge Fire & Water, Sowerby Bridge HX6 2QG. Telephone: 07572322200.

We take your data security seriously and will never sell or swap your details with third parties. You can withdraw your consent for Imagineer to store your data at any time by calling 07572322200 or emailing info@imagineer.org.uk. Information about how we protect and use your personal data is set out in our Data Protection Policy which we can send you a copy if you wish to see this.

If you require having access to the personal information Imagineer has stored about you please could you request this in writing to Imagineer Development UK CIC, Sowerby Bridge Fire & Water, Sowerby Bridge HX6 2QG.

If at any time we have made an error with your personal details – please tell us!
We will then rectify the error on our systems – then inform you in writing.

Please leave this field empty.

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