Thank you for volunteering to help any villagers that are having problems as a result of the coronavirus outbreak. Please complete the information below to assist us in assigning you to the person requiring assistance.

Your Name (required)

Your Email (required)

Your phone number (required)

Your address (required)

Please tick which of the following you are prepared to help with.
ShoppingDogwalkingCollecting prescriptionsOther (please outline below)

Other ways you feel able to help.

We appreciate that you may not be available all day, please indicate when you are not available, times and days if possible.

We are looking at operating a buddy system with those needing help, this would involve you telephoning the person once or twice a week to check that they have everything they require and to be a "friend" to them.

Would you be prepared to be a buddy?
YesNo

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