To become a Harrow Community Action (HCA) Partner please complete this form only.

On completion of this form (stage 1) organisations will be assessed and where appropriate be invited to complete stage 2.

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* 1. Organisation Name

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* 2. Contact name:

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* 3. Organisation Address

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* 4. Phone Number

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* 5. E-mail address

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* 6. Website

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* 7. What is your legal status? (please tick all that apply)

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* 8. Approximately how much of your work is delivered in Harrow / for the benefit of Harrow residents?

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* 9. What does your organisation do? (please tick all that apply)

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* 10. Who does your organisation help?

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* 11. Do you have a track record of working with vulnerable, marginalised and excluded individuals and communities? Please give an example.

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* 12. How do you involve your service users or local communities in the planning and monitoring of your services e.g. feedback forms.

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