Pennine Care NHS Foundation Trust

Member type

Title

First name *

Last name *

Middle name

Date of birth *

DD MM YYYY

Gender

Please enter your postcode, and click Get Address

Address *

Town or City

County

Postcode *

Country

Home telephone

Mobile

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Email

Preferred method of contact

Email

Post

Telephone

Ethnicity

Do you have a visual or physical disability?

No

Yes

Activity Preferences

Consider standing for election as a Governor

Find out more about the work of the Trust

Take part in consultation of the Trust's plans

Learn more about the services of the Trust by attending seminars

Volunteer at the Trust

Interested in elections

How did you hear about the trust?

Patient Mailing

Face to face recruitment

Through an employee of the Trust

Website

Service User

Carer

Other (please list in 'Notes')

Community Services

Member type

Last Used Services

Title

First name

Last name

Middle name

Date of birth

Gender

Address

County

Postcode

Country

UK

Home telephone

Mobile

Email

Ethnicity

Preferred method of contact

Do you have a visual or physical disability?

Activity Preferences

How did you hear about the trust?

* I apply to be a member of Pennine Care NHS Foundation Trust and be bound by the rules of the organisation. I give consent to the processing of my information. Please click here to see how we use your information.

The data you supply will be used only to contact you about the Trust, membership or other related issues and will be stored in accordance with the current Data Protection Act. Please click here for full details.

This animation has everything you need to know about becoming a member and governor at Pennine Care, including their role, why it's important and how to get involved.

Please tick here if you consent to your details being added to the Public Register.