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* 1. Would you be interested in being involved in groups helping Wythenshawe become a better place to grow older?

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* 2. How much time, per month, would you be willing to give if you become involved in the community group. e.g. 1 - 2 hours

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* 3. If you were involved with the community group, which of the below options would you be interested in helping with?

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* 4. If you were involved in the Wythenshawe Age Friendly Network, would you be interested in any of the following

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* 5. What is your name?

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* 6. Are you

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* 7. Please provide your age

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* 8. With which method would you prefer the Age Friendly Team to contact you

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* 9. If you would like to be involved in the Age Friendly Network at what email address would you like to be contacted? (Please note that we need  this to contact you further)

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* 10. If you would like to be involved in the Age Friendly Network with what contact number would you like to be contacted? (Please note we need this to contact you further)

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