Where you live Please check if you live in Newcastle here Do you live in Newcastle? * Yes No Accomodation Do you have a spare bedroom? * Yes No Contact Details First Name * Surname * Postcode * Address 1 * Address 2 * Address 3 Daytime Telephone Number * Email Address * Perferred Contact Method Preferred method of contact (choose one) * Email Telephone More details Any other details you would like to tell us? Where did you hear about us Where did you hear about shared lives? Recommended by a shared lives carer NCC Job vacancies Facebook or Twitter NCC Website Word of Mouth Other Any other details Other Agree and confirm Agreement * The information you have provided above will be held on our database and will be used to assess your suitability as a carer. It will also be used for statistical purposes. The information will also be used to do a background check. Please tick here if you provide consent for this information to be held and used as stated Confirm Submit
