Support Request Form - Counter-Col Network

Support Request Form (SRF)

CCN Support

Name
First Last
Phone
Email
Industry
Job title
Select options the reason that best reflects your reason for contacting CCN Support:
- Select All
- Need support with an issue that is impacting my working life and wellbeing
- Would like support with a specific HR process I am currently facing
- Require legal support to deal with an emerging / ongoing workplace issue
- Feeling stuck in my career and would like support to explore my options
- Would like to explore opportunities for coaching / mentoring support
- Other (please specify below)
Other (description of issue)
Please provide a some details of support your require:
Please tick box and sign below to indicate you have read and agree with this statement. I understand that CCN may offer some support regarding my working life experiences, to explore some options that may be available to me based on the information that I have provided. CCN do not assume any responsibility for the decisions I may choose to make. By completing this form I am consenting to CCN holding my personal data. I understand that I have the right to request to withdraw my consent at any time by contacting CCN in writing.*
I consent.

What happens now?

We are pleased that you have taken a step today to reach out for support. We will endeavour to make contact with you by email/telephone within 2 working days of receiving your completed SRF. This may in the first instance be to obtain further information from you for the purposes of clarification so that we can process your request. Once we have sufficient information from you, we will allocate your SRF to a ‘Responder’, usually a subject expert in the category of support you have indicated.

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