Tackling Loneliness Together: Enquiry Form

Thank you for showing an interest in the Tackling Loneliness Together project.

Please spare a few moments to fill in a few details below and someone will be in touch with you soon.

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* 1. Are you an organisation or an individual? Please select.

Organisation

Individual

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* 2. Are you wishing to receive the following support: Select all that you are interested in?

Telephone befriending calls

Newsletter

Garden Gate Visits (socially distanced)

Access to weekly zoom sessions

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* 3. Is it okay to contact you by:

	Yes	No
Email	Email Yes	Email No
Telephone	Telephone Yes	Telephone No

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* 4. If you entered yes to being contacted by email and or telephone, please enter your details

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* 5. Any additional queries?