Professional Documents
Culture Documents
to:
Evelyn Asante-Mensah at evelynasante-mensah@hotmail.co.uk tel: 07825 283227
Revd. Ian Hamilton at ian.p.hamilton@virgin.net tel: 0161 2265833
The meal is being organised by Whalley Range Methodist Church
Supported by Arawak Walton Housing Association; City South Housing Association; Out
of the Blue (Chorlton) Unicorn Grocery (Chorlton)
Nomination form
Nominees details
Name:
___________________________________________________
Gender:
_____________________________________________
Age:
____________________
Address:
____________________________________________________
____________________________________________________
____________________________________________________
Yes / No
We are unable to offer a place to people who have significant support needs,
unless they are accompanied by a carer.
Transport Needed Yes / No
Does the person have mobility issues
________________________________
_________________________________________________________________
_________________________________________________________________
Referral agency details: