Mobility, are you able to move freely without assistance? (This is just for us to assess your needs and will not exclude you from the project) *
Required
Do you live alone or do you have a partner or family living with you? *
Your answer
Do you have family living locally? *
Required
Are you able to commit to a 10-week project from February to April? This will be just one day per week for 2/3 hours in the morning. *
Required
Are you happy to have a police check? *
Required
Are you happy to be part of this project and answer questions about your general health and mood before and after the project so we can assess the benefits the project on your health and wellbeing? *
Required
Would you like to be picked up and brought to the centre each week? *
Required
Address *
Your answer
Email address *
Your answer
Telephone Number *
Your answer
Thank you for your interest in the project.
If you have any questions or would like any further information please don’t hesitate to contact Mark Labrow 9550 3986 or Alison Pinder 9550 3920.