JustBe Carefree (2019)

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JustBe (www.just-be.co.uk) will be providing a complimentary 'carefree' afternoon out for female Carers aged 18+ and living in London on DATE. Places are limited and will be chosen at random, but we're taking as many as we can for a relaxing afternoon tea. If you would like to nominate yourself, or somebody you know please complete the form below. This will take place at WHERE and attendees will need to be responsible for their own travel arrangements. Please email events@just-be.co.uk should you require an assistance submitting a nomination.

Your Email Address *

Your Name *

Your Contact Address (please include organisation name if applicable) *

Your Contact Telephone Number *

How would you prefer we contact you? *

Phone

Either Email or Phone

Are you applying on behalf of somebody else? *

Yes (please go to next question)

No (please skip next question)

Please give Name, Email, Telephone and Address of the individual you would like to nominate

Please tell us the age of the person being nominated *

18-24

25-35

36-45

45-54

55+

Prefer not to say

This Carefree event is for women living in London only, please confirm this nomination is for a woman who lives in London *

Yes, this nomination is for a woman who lives in London

Required

Please state which borough: *

Briefly tell us (in 50 words or less) who do you/the nominee care for AND why you/the nominee would like to attend a JustBe Carefree afternoon *

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