Tuesday, September 02, 2014

Working Together
to end Homelessness

StarterPacksForm

Client/Agency information
Date of referral*
Referring Agency*
Name of Agency Representative*
Agency Address
(Please include Postcode)*
Agency Contact Number*
Agency E-Mail address*
Client Name*
Client Address*
Client Postcode
(To assist with delivery)*
Client Contact Number*
Do you require a Starter Pack*?
(*=Crockery, Cutlery, Pots, Pans, Cooking Utensils and Towels)

Starter Pack Information
Please state whether the Starter Pack will be
delivered direct to client, or to Agency*
Number of Adults*
Other
Please list how many children, if any, under 16, specifying Male/Female and ages.

What bedding is required? 
(One per family member
)

Double Bed
Single Bed
Child
Curtain sizes required
(NOTE: Only two sizes available at present)

Number of pairs of curtains (No more than 2)
Submit

Contact Details

Churches Action for the Homeless
188-190 High Street
Perth
PH1 5PA

CATH is a charity registered in Scotland No. SC021740

Quick Links

About Us
Volunteers
Contact Us
Copyright © 2013 Churches Action for The Homeless