Organisation Name  
  Statement about benefit and for which "group" of people  
  Description of service or support provided by the group  
    The benefit statement and description should together be no more than 85 words so that the total entry, with the contact details below, is no more than 100 words  
  Meetings / service access dates  
  Meetings / service access times  
  Meetings / service access venue  
  Meetings / service access contact person  
  Meetings / service access telephone  
  Meetings / service access email  
  Website address  
  Comment box in case the above fields are not sufficient  
  Would you like to include a small logo? Yes     No     if yes please email the logo to admin@farehamaction.org.uk  
  I agree to the information in the red area to be published electronically or in printed matter Yes  
       
  Your Name  
  Yours or Admin's  email  
  Yours or Admin's telephone