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* 1. Please complete the details of the Young Adult wishing to be included in the programme.

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* 2. Does your Young Adult currently access any daytime Adult Services?

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* 3. How long would you prefer the session to be?

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* 4. What day of the week would be more suitable for your Young Adult to attend a session?

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* 5. What skills would your Young Adult like to gain from the skills workshops? (please select all that apply)

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* 6. Would your Young Adult be able to attend with a 3:1 care ratio?

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