Referrals / How to get in

To become a member of The Outdoor Club’s Ecominds Project simply complete the online form below to start the ball rolling.

Once you have completed the form below (please fill out ALL questions) click on ‘SEND NOW!’ and your application will be sent straight to us. When we get your form, we’ll give you a ring to arrange a meet up at one of our intake days.
N.B. If you have any trouble filling this in then do get someone to help or go to The Neetside Community Centre in Bude and fill in a paper application there or alternatively contact us.

1. Applicant Details:-

Full Name*:
Your Email*:
Address*:
Postcode*:
Tel Number*:
Date of Birth*:
Gender*:
M F 
Nationality*:
Emergency contact*:

2. Present Support:-

Are you receiving help from anyone at the moment, friends, family, self help groups, GP, Social worker, mental health worker?

If 'Yes' please advise:

3. Consent to Share:-

Please give contact details of anyone who is supporting you who you would be happy for us to talk to.

Support contact:

4. Personal Details:-

Please give details where relevant.

General Health Issues:
Physical Disabilities:
Learning Disabilities:
Mental Health Issues:

5. Other relevant information:-

Please let us know of any other information that you feel we should know.

Other information:

6. Why you are interested:-

Why would you like to become a member of this group? How do you see being a member of this group being of help?

Why you are interested:
How it will help:

7. How you found out about us:-

How did you find out about the Outdoor Club's Ecomind Project?

How did you find us?:

Come along and meet us – sign up as a club member for a term.