Volunteer agreement and Baseline Survey
Gasworks Dock Partnership would like your help with the ongoing development of Cody Dock and future events by providing feedback to this questionnaire.

By completing this form, you are confirming that you are happy for Gasworks Dock Partnership to hold and use your details in line with our Data Protection Policy.

You can opt out of this agreement at any time by contacting us.

PLEASE READ

Click on link for Cody Dock's Volunteer Charter

I have read and agree to adhere to Cody Dock's Volunteering ways of working

Have you volunteered at Cody Dock Before?

YesNo

Area of Support

Volunteers

Personal Details

Forename

Surname

Email address

Mobile

Home Phone

Area of residence

Newham/Tower HamletsOther London BoroughOutside London

Address Line 1

Address Line 2

City

Country

Postcode

Next of Kin

Forename

Surname

Contact number

Next of kin address line 1

Postcode

Your current use and knowledge of Cody Dock

How often do you visit Cody Dock or go walking in the River Lea area?

This is my/ our first time at Cody Dock/ River LeaSeldom: less than once a monthSometimes: about once a monthRegularly: at least once a fortnight

How much do you know about...

Volunteering Information

What activities do you want to be involved in and receive updates about? (tick all that apply)

Citizen Science & Group Activities

Canoe based activitiesCommunity litter picksTree planting

What are your skills and interests

Which of the following statements best describes your reasons for being here?

How do the following factors influence your decision to volunteer at Cody Dock
Rate your answer 1 - 5; 1 being the exactly why I am here, 5 being the not at all why I am here, n/a if the option does not apply.

	1	2	3	4	5	n/a
To meet new people
To share my skills and experience
To learn new skills
To support my local community
Active/healthier lifestyle
To have fun
To find out more about the local ecology and heritage
To increase my confidence
To improve my leadership skills
Other

If other please specify

How do you agree with the following statements?

Rate your answer 1 - 5, 1 being the highest, 5 being the lowest and 3 being a neutral experience.

	1	2	3	4	5
The heritage of the local area is well publicised
The Line sculpture trail and Cody Dock makes a difference to how I feel about the area
Newham has lots of opportunities to get involved in the community if I want
It's clean, well - kept and a safe place to live
It has interesting things for people to do
It has places to meet, relax and enjoy life - I am happy to live here
It has some nice public spaces, parks and open spaces
I would like to stay/live in this part of London for many years
I think this part of London is going places

How do you agree with the following statements?

Rate your answer 1 - 5, 1 being the highest, 5 being the lowest and 3 being a neutral experience.

	1	2	3	4	5
I get out and socialise often
I lead a healthy lifestyle
I enjoy and utilse local amenities
I strive to learn and gain new skills
I feel involved in what goes on in my local area
It's easy to to socialise with people of different backgrounds and generations near where I live
I feel that my view or opinions are noted and that I can make changes in my neighbourhood

Demographics

Age

To which gender identity do you identify?

Not Listed, please specify

Ethnic Origin

Ethnic Group

Ethnic Group

If other please describe

Ethnic Group

Ethnic Group

If other please describe

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Ethnic Group

Ethnic Group

If other please describe

Ethnic Group

Ethnic Group

If other please describe

Ethnic Group

Ethnic Group

If other please describe

General Health

Do you have any disabilities or health conditions you feel could impact volunteering?

YesNo

You are not required to disclose these conditions, however if you feel it would be important for GDP staff to know to manage your safety at Cody Dock, please disclose below. Alternatively if you would like to speak in person about this please put yes and we will arrange a short meeting.

Contact Information

	Nothing	Very little	A little	Quite a bit	A lot
Lower Lea's Heritage
The lower river Lea's ecology