Services in Washing and dressing (0)

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1 Who are you?

Child Young Person Parent/Carer Practitioner Other:

2 How did you hear about Help & Support Manchester?

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3 Why were you visiting the directory today?

4 Did you find the information you were looking for?

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Please complete the sections below. We will work with our partners to address any gaps in childcare that we are made aware of.

1

Name:

Postcode:

Telephone:

2How many children do you need childcare for?

I have How many children do you need childcare for? Please choose... 1 2 3 4 5 children What is the age of the eldest child you need childcare for? Please choose... 1 2 3 4 5 years old or under

Please give the ages of your children:

3How many days do you need childcare for each week?

Days per week Please choose... 1 2 3 4 5 6 7

4 Please describe your childcare needs:

Special Educational Needs & Disabilities Variable hours each week (please give details) Unusual hours Weekend care Shift work Other: