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Join the Agoriad Database

This information will be put on a database of community designers in Wales, and will be accessible to community/voluntary groups looking for professional design services, with the database available as a directory and on the internet. On returning this form you will accept the conditions of the Data Protection Act.

General Information

Company Name
Contact Name
Job Title
Your Address
Post Code
Telephone Number
Fax Number
Email
Website Address
Professional Memberships

Number of employees in company:

Please Select From This Menu

MARK ALL BOXES THAT APPLY TO YOUR COMPANY


Languages Used

English
Welsh
Other

Area of operation


Wales
South Wales
Mid & West Wales
North Wales

Please indicate your usual client base:

Businesses
Churches
Community Groups
Developers
Government Agencies
Individuals
Local Authorities
Statutory Bodies
Other

Which skills does your company Offer?


Architectural Design
Building Conservation
Building Surveys
Community Development
Cost Estimates
Desk Top Publishing
Disability Access
Electrical Engineering
Exhibition Design
Environmental Appraisal
Feasibility Studies
Funding & Fundraising
Graphic Design
Habitat Creation/Surveying
Interior Design
Landscape Design
Landscape Conservation
Landscape Management
Land Reclamation
Lighting
Low Energy Design
Mechanical & Heating Engineering
Office Planning
Planning Supervisor
Project Management
Quantity Surveying
Refurbishment Schemes
Structural Engineering
Site Surveys
Urban Design
Web Design
Other

What type of work have you undertaken in the past 4 years?


Annual Report
Community Arts
Community Enterprise
Community Halls
Displays
Early Years Care
Educational
Environmental Improvement
Estate Improvements
Gallery or Museum
Gardens
Health
Housing
Landscape Management
Library
Lottery Applications
New Build
Offices
Play Facilities
Promotion and marketing
Publicity (Leaflets, Logos, etc)
Refurbishment/Alteration
Religious
Sports Grounds
Sports Hall/Facilities
Theatre/Cinema
Woodland
Workshops & Studios
Other

Has your company experience of any of the following:


Action Planning
Community Participation
Consultation Excercises
Group Facilitation
'Planning for Real' type exercise
Team Building
Tenant Participation
Other

Does your company have Professional Indemnity Insurance


Yes
No
Limit of Indemnity £

Does your company have the following policies available:

Community Design Philosophy
Environmental/green
Equal Oppurtunities
Health & Safety

Does your company work on:


Fee Basis
Grant Aided
Speculative
Voluntary

Do you charge a:

Daily Rate
Flat Rate
Percentage

Do you charge for an initial meeting?


Yes
No

Have you attended any of the Agoriad Training days or other training on how to work with communities?

Yes
No
Other Training

Practice Information - Please keep under 100 words


Practice Information


Practice Experience - Please keep under 100 words


Practice Experience


Community Projects - Please keep under 100 words


Community Projects


References


Reference i
Reference ii

I agree that this information provided is correct and I agree to have this information transferred to a database of community designers in Wales.

Name
Company
Date