Apply to be a Playlist for Life Help Point Apply to be a Playlist for Life Help Point Thank you for your interest in hosting a Playlist for Life Help Point. Please take the time to fill out this short form. Your details First Name Last Name Contact number Email Your organisation details Name of organisation Your position or job title Organisation street address Town or city County Post code Help Point Information Which type of Help Point would you like to set up? (More information on the two types of Help Points can be found in the description above.)Please select... Help Point Information Only Helping Hands Help Point Will the Help Point be based at a different location to the details you have given us above about the host organisation?Please select... Yes No - it will be held at the address listed above Location name Location street address Town or city County Post code Please tell us why you think this would be a good place for a Playlist for Life Help Point. Lead Contact Information Will you be the lead contact at your Help Point?Please select... Yes, I am the lead contact No, the lead contact is someone else Lead contact first name Last name Job title Email address Lead contact phone number How many others will help run your Help Point? Have you, or anyone from your Help Point, attended one of our free Help Point Training days?Please select... Yes No Where did this training take place? On what date did the training take place? Who will be accessing the Help Point? Please provide answers to the following questions giving an estimated number where you don't know the exact number. PLEASE INSERT NUMBERS ONLY. Approximately how many people use your service on an average week for any services (not just dementia related services)? Approximately how many people with dementia access your service on a monthly basis? If unsure, state an estimate based on your total number of service users. As a guide, 6.8% of people over 65 in the UK are living with dementia Approximately how many carers will be using the Help Point? Other information Does your organisation have a safeguarding policy for vulnerable groups?YesNo Do you have a computer or laptop which can be used to train volunteers and to help with researching playlists?YesNo Do you have access to the internet?YesNo Do you have a wall space 42 x 60 cm OR 17 x 24 inches to display your sign?YesNo Do you have a table or space to display the additional materials with visitors can take away with them?YesNo How did you hear about becoming a Help Point?Please select... Facebook Instagram LinkedIn Playlist for Life Website Twitter Other (please specify) If 'other', please specify Thank you for taking the time to contact us and provide this information. A member of the Playlist for Life team will be in touch. reCAPTCHA helps prevent automated form spam. The submit button will be disabled until you complete the CAPTCHA.