Degree Research Befriending

Name

First

Last

Phone Number *

Address *

Email *

I am loooking for the following to become more connected to other people

To join a friendship club
To join a club where others have my interests to share
For a befriender to visit me at home
For someone who I can speak to on the phone regularly
I am happy to have a call with someone using a video call
There is someone I know who needs support
None of these

If support is for someone else what is their name and contact number?

I give permission to hold my details for the research / I have permission to share my friends details for the research and understand all will be destroyed within 3 months of the end of the research *

I give permission (please tick)