Please confirm:
*
Our Panoramic support is for children and families who have been affected by abuse and neglect and are living in financial hardship. We work compassionately to provide wide ranging packages of meaningful long-term and therapeutic support, including access to long term therapy, enrichment activities and support for parents/carers.
Parent/Carer Name
*
First Name
Last Name
Email
Phone
*
(###)
###
####
Address
Which service are you enquiring about support for?
*
Child's Name
*
First Name
Last Name
Date of birth
*
MM
DD
YYYY
Gender and pronouns
Child's ethnicity
Main language(s) spoken
Address (if different to parent/carer above)
Child's school and address (if applicable)
Main school contact (if applicable)
Does your child have an EHCP?
If yes, please describe your child's needs
Is your child eligible for pupil premium?
Is your child eligible for free school meals?
We’d like to know as much about the reason you’re getting in touch with us as you’re comfortable sharing here. Please know you’re also welcome to call us, email us any other forms where it might be written down, or put “call back” in the box below and we’ll reach out for a conversation.
Has your family accessed any support in the past?
Are you accessing any other services?
Please can you tell us about your child's strenghts and any activities they might enjoy doing?
Have you visited any of our wellbeing hubs?
Before submitting this form, please ensure that you have read and agree to Cambridge Acorn Project’s Terms of Service (available at the bottom of this page)
*
By ticking yes and submitting this form your are confirming that:
• You have parental responsibility
• You agree to share the information provided in this form with Cambridge Acorn project and are aware that Cambridge Acorn Project will safely store this information.
• This form contains accurate information.
• You consent to Cambridge Acorn Project delivering services in response to your enquiry (when applicable)
• You agree to Cambridge Acorn Project’s Terms of Service
If you do not agree, please do not submit this form.
Please type your name
*
Submission date
*
MM
DD
YYYY
