Information on Terms Used in this Form

What is personal and sensitive data?

Personal data is data which can be used to identify you. This may include your name, date of birth, address, telephone number etc. Sensitive data is information related to any of the following: racial or ethnic origin, political opinions, religious beliefs, trade union membership, health, sexuality or sex life, offences and/or convictions.

Where will you store my data?

The record of your case will be stored in a shared electronic case management system accessed by members of FACE. Your information may also be stored in a paper file held securely by FACE.

What is a Data Controller?

A Data Controller is someone who is responsible for your data and who must make sure that your data is processed according to the law. For example they are responsible for making sure that the information held about you is accurate and that it is kept secure.

Can I withhold my consent?

Yes we will not record your information unless you provide your consent. We will not share your information with anyone else without your consent, unless required to do so by law.

Faversham Assistance Centre (FACE)

Data Protection Act – Client Consent Form

In order for us to help you with your enquiry we may need to record details of your case. These details may contain your personal and sensitive data. To comply with the Data Protection Act (1998) we must tell you how we use this data and ask for your permission. By signing this form you are providing your permission for us to process your data for the purposes below. For further information please see the back page titled ‘Information on Terms Used in this Form’. Permission to store your data We are required by law to ask for your permission to record the details of your case. These details may contain your personal and sensitive data. The record of your case will be stored in a shared electronic case management system accessed by members of FACE. Paper copies of your data may also be stored securely by FACE. For the purposes of the Data Protection Act the members of FACE are Data Controllers.

Data Protection Act

In order for us to establish your eligibility for our services we may need to record details of your case. These details may contain your personal and sensitive data. To comply with the Data Protection Act (1998) we must tell you how we use this data and ask for your permission. By signing this form you are providing your permission for us to process your data for the purposes required.

Client Information Form – Registered Charity No: 1172770

Downloadable Client Information Form in PDF format Click to download

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Donations

Our services are provided free of charge on a labour only basis to the elderly or disabled people who are on benefits or low income with no one else to turn to. We can only continue to help people through generosity or their donations.  The suggested donation is £12 per hour, but please give as much as you are able.

Thank you for completing this form.  We will access the information you have provided and contact you shortly.