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MYCaW® NON-COMMERCIAL APPLICATION

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MYCaW® NON-COMMERCIAL APPLICATION

Application form for Non-Commercial Licence to use Measure Yourself Concerns and Wellbeing (MYCaW^®)

Please complete the form below to register your non-commercial MYCaW^® licence.

If your organisation is profit making please apply via a commercial MYCaW^® licence.

Please be aware that the Non-Commercial licence does not give you permission to publicly share MYCaW^® or its guidance notes or for you to provide MYCaW^® to other parties for their use under your licence.

1) Where did you hear about MYCaW^®? (e.g. Google search, word of mouth)

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2) Where did you hear about Meaningful Measures? (e.g. Google search, word of mouth)

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3) How are you planning to use the tool? Select all that apply*

Using as a consultation tool

Continuous monitoring of a service (audit)

Evaluation of service for a set period of time

Research project

Other - explain below

Please tell us how you will be using the tool

Other Usage

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4) What organisation do you work for? Tick all that apply*

Registered Social Enterprises

NHS or other Public Health

Social Services

NGOs

Other - explain below

Please tell us what organisation you work for

Other Organisation

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5) Which version of the tool do you require (select one):*

A paper version

Digital portal version

Integrated into your own digital platform

Integrated into the Access Elemental Software, Joy or help@hand digital platforms

Please choose the version required

If you have a discount code, enter it below

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6) Over the duration of the one-year licence approximately how many people are you planning to use the tool with?*

Please tell us approximately how many people are you planning to use the tool with

7) How many staff/people/practitioners in your organisation would give out (administrate) the questionnaire?*

Please complete the question

8) Do you know what your start date is?

Not Sure

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9) Start Date

Please choose a correct date

10) Do you know what your end date is?

Not Sure

Rolling end date

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11) Approximate end date

Please choose a correct date

12) In which country (countries) will you be using the tool?*

Please choose the country of use

About You

Name*

Please tell us your name

Job Title*

Please tell us your job title

Please tell us your email

Organisation Name*

Please tell us your organisation's name

Organisation's Registered Address*

Please tell us your organisation's registered address

Company Registration Number (if applicable)

Organisation’s Website

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Terms & Conditions

I understand our anonymised data will be shared with Meaningful Measures at the end of the 12 months licence period. (Shared data will only be qualitative and quantitative data and will not contain any identifiable info (names, dates of birth etc). Meaningful Measures will pool this data to create larger anonymised data sets. Full details are given on the licence form and please click here for our Data share policy.*

Yes

Please advise us that you understand

I have read and agreed to the terms of Meaningful Measures’ Privacy Statement*

Yes

Please accept our Privacy Statement

Would you like to be kept informed of developments from Meaningful Measures regarding MYCaW^® and MYMOP^® tools?*

Yes

Please tell us if you would like to be informed of developments

I understand that there is a non-refunable administration fee of £54.80 (+VAT) for the generation of my 12 month bespoke tool licence, my bespoke questionnaire tool, and my support document package for the tool including updated guidelines for use of the tool.**

Yes

Please accept our terms.

All personal information supplied on this form will be processed by Meaningful Measures Ltd, in accordance with GDPR and the Data Protection Act (2018).

Limited Company: 12800470
VAT Number: 437 0766 83
Registered Address:13 St Mary's Park Road, Portishead, Bristol, BS20 6SN

MYCaW® NON-COMMERCIAL APPLICATION

About You

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