Registration Form For Care Farms


* required field
Farm/Project name
*
Parent Farm Name
Main Contact Name *
Address Line 1 *
Address Line 2
Town
County *
Region *
Postcode*
Telephone
Alternative Telephone
Email Address *
Website
Category *
Password

Password should be a minimum of 6 characters and ideally contain both letters and numbers.

*
Description of farm / project
Secondary Contact Name
Image of Project (if applicable)
Small Image 1
Small Image 2
Small Image 3
Tick if you agree to our terms & conditions

  terms & conditions *
Questionnaire
1.) Which of the following best describes your site? (please tick only one box)
Other (please specify)


2.) What kind of organisation are you? (please tick relevant boxes)
Other Local Auth (please specify)
Other


3.) Does your farm make provision for residential clients?


4.) Who are the main groups of people that attend the care farm? (by main we mean approx 20% or more of people who attend)
Other (please specify)


5.) Which of the following describes what your farm / project provides? (please tick all relevant boxes)
Other (please specify)