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Worcestershire County Council
Offer of help
Instructions
Please fill in this form if you are able to offer assistance and support in Worcestershire during Coronavirus (COVID-19).
1
Your Details
Are you:
An individual
Working with a Mutual Aid Group, Charity, Business or Neighbourhood Group
First name
Surname
Contact Method (our preferred method of contact is email, but if not available please supply a telephone number)
Email
Telephone Number
Do have you a Disclosure Barring Service (DBS) certificate? (Please note if one is required, we will follow up directly with you)
-- Please Select --
Yes
No
Please select the type of DBS clearance you have?
-- Please Select --
Standard Clearance
Enhanced Clearance
Please upload a copy of your DBS check
File Name
No files uploaded...
Please use the postcode finder below to locate your address. If your address does not appear in the list, please select the 'My Address is not in the List' option, and fields will appear for you to enter your address manually.
Please enter your postcode, find the address, then select from the list
Postcode
Please enter a valid Worcestershire postcode, e.g. WR1 1PT
Don't know your postcode?
Find it here
-- Please Select Your Address --
Please select which district you live in
-- Please Select --
Bromsgrove
Malvern Hills
Redditch
Worcester City
Wychavon
Wyre Forest
How many miles outside of your postcode are you willing to offer support?
-- Please Select --
1 mile
3 miles
10 miles
County wide
2
Details of Help Offer
Which of the following categories can you offer help in?
Food and Supplies
e.g. deliver or donations
Health and Medication
e.g. collecting and delivering prescriptions
Commitments
e.g. child care, pet needs, transport
Licensed HGV Driver
Connectivity and Entertainment
e.g. access to the internet
Mental Health and Wellbeing
e.g. offer resources to support people
Business and Money Matters
e.g. accountancy
Other
Please tell us as much information as you can about the help you can offer
Please note that we may need to share details with third parties in order to mobilise appropriate help for people. Please confirm if you agree to us sharing your information with:
Third party organisations e.g. your local council, voluntary, community and charities who may be able to utilise your offer of help or support.
An individual who has requested the type of help or support you are offering.
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