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* 1. Name of Person Registering

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* 2. Email Address

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* 3. Contact Number (optional)

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* 4. Name of Organisation

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* 5. Town

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* 6. County

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* 7. Organisation Postcode

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* 8. How did you hear about Learning Together?

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* 9. Geographical Region

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* 10. How would you describe the predominant geographical reach of your organisation?

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* 11. How would you describe your organisation?

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* 12. Which communities does your organisation support?

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* 13. What type of services do you provide?

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* 14. What are your main reasons for choosing to be a part of Learning Together?

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* 15. In terms of your social prescribing work, which of the following themes would you like to explore through the programme?

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