The information on this form will be held in an internal database maintained by Pembrokeshire Association of Voluntary Services (PAVS). The information will be made available to the public as follows:- Verbally or via email by PAVS staff in response to enquires In printed format Via a Searchable On-line Directory on the internet.

Your Contact Details

1.	Organisation Name

2.	Contact Name

3.	Address

4.	Telephone Number: Day

5.	Telephone Number: Night

6.	Email address

7.	Website address www.

Area Served

8.	Which area do you deliver services in?
	North Pembrokeshire
	Mid Pembrokeshire
	South Pembrokeshire
	Pembrokeshire wide
	West Wales
	Nationally

Organisation Description

9.	Please give us some basic information about your organisation

Please let us know the areas your organisation works in, in order or priority where the first answer is your main area of work.

10.

What is your main area of work?

--Click Here--AdvocacyAdvice and InformationAnimal WelfareArts Drama MusicCarer Carers OrganisationCarers Support GroupChildren GeneralChildren Learning DisabilityChildren Physical DisabilityDisability GeneralEnvironmentalHealth GeneralHealth MentalHealth SexualHeritage and CultureHousing GeneralHousing HomelessnessInformation GeneralMen’s IssuesOlder PeoplePhilanthropic GroupSocial EnterpriseSport & RecreationTransport VoluntaryVillage HallWomens IssuesWomens InstituteYoung FarmersYouth

11.

What is your second area of work?

--Click Here--AdvocacyAdvice and InformationAnimal WelfareArts Drama MusicCarer Carers OrganisationCarers Support GroupChildren GeneralChildren Learning DisabilityChildren Physical DisabilityDisability GeneralEnvironmentalHealth GeneralHealth MentalHealth SexualHeritage and CultureHousing GeneralHousing HomelessnessInformation GeneralMen’s IssuesOlder PeoplePhilanthropic GroupSocial EnterpriseSport & RecreationTransport VoluntaryVillage HallWomens IssuesWomens InstituteYoung FarmersYouth

12.

What is your third area of work?

--Click Here--AdvocacyAdvice and InformationAnimal WelfareArts Drama MusicCarer Carers OrganisationCarers Support GroupChildren GeneralChildren Learning DisabilityChildren Physical DisabilityDisability GeneralEnvironmentalHealth GeneralHealth MentalHealth SexualHeritage and CultureHousing GeneralHousing HomelessnessInformation GeneralMen’s IssuesOlder PeoplePhilanthropic GroupSocial EnterpriseSport & RecreationTransport VoluntaryVillage HallWomens IssuesWomens InstituteYoung FarmersYouth

13.

What is your fourth area of work?

--Click Here--AdvocacyAdvice and InformationAnimal WelfareArts Drama MusicCarer Carers OrganisationCarers Support GroupChildren GeneralChildren Learning DisabilityChildren Physical DisabilityDisability GeneralEnvironmentalHealth GeneralHealth MentalHealth SexualHeritage and CultureHousing GeneralHousing HomelessnessInformation GeneralMen’s IssuesOlder PeoplePhilanthropic GroupSocial EnterpriseSport & RecreationTransport VoluntaryVillage HallWomens IssuesWomens InstituteYoung FarmersYouth

14.	Does your organisation work in any other areas you have not already told us about? You may tick as many as required.
	Advocacy		Heritage and Culture
	Advice and Information		Housing General
	Animal Welfare		Housing Homelessness
	Arts Drama Music		Information General
	Carer		Men’s Issues
	Carers Organisation		Older People
	Carers Support Group		Philanthropic Group
	Children General		Social Enterprise
	Children Learning Disability		Sport & Recreation
	Children Physical Disability		Transport Voluntary
	Disability General		Village Hall
	Environmental		Womens Issues
	Health General		Womens Institute
	Health Mental		Young Farmers
	Health Sexual		Youth

Please give us the details of the services you provide, via a contract, in Pembrokeshire

Service 1

15.	Name of project, activity or service

16.	Operating from (address if different to main address

17.	Description of project, activity or service provided

18.	Project start and finish date
	Start Date
	Finish Date

19.	Target group(s), e.g. children, adults with mental health issues, etc.

20.	Please tick the age group(s)
	0-10
	11-25
	26-49
	50+

	Other

21.	Area served by this service
	North Pembrokeshire
	Mid Pembrokeshire
	South Pembrokeshire
	Pembrokeshire wide
	West Wales
	Nationally

22.	Would you like to add another service?
	Yes
	No

Service 2

23.	Name of project, activity or service

24.	Operating from (address if different to main address

25.	Description of project, activity or service provided

26.	Project start and finish date
	Start Date
	Finish Date

27.	Target group(s), e.g. children, adults with mental health issues, etc.

28.	Please tick the age group(s)
	0-10
	11-25
	26-49
	50+

	Other

29.	Area served by this service
	North Pembrokeshire
	Mid Pembrokeshire
	South Pembrokeshire
	Pembrokeshire wide
	West Wales
	Nationally

30.	Would you like to add another service?
	Yes
	No

Service 3

31.	Name of project, activity or service

32.	Operating from (address if different to main address

33.	Description of project, activity or service provided

34.	Project start and finish date
	Start Date
	Finish Date

35.	Target group(s), e.g. children, adults with mental health issues, etc.

36.	Please tick the age group(s)
	0-10
	11-25
	26-49
	50+

	Other

37.	Area served by this service
	North Pembrokeshire
	Mid Pembrokeshire
	South Pembrokeshire
	Pembrokeshire wide
	West Wales
	Nationally

38.	Would you like to add another service?
	Yes
	No

Service 4

39.	Name of project, activity or service

40.	Operating from (address if different to main address

41.	Description of project, activity or service provided

42.	Project start and finish date
	Start Date
	Finish Date

43.	Target group(s), e.g. children, adults with mental health issues, etc.

44.	Please tick the age group(s)
	0-10
	11-25
	26-49
	50+

	Other

45.	Area served by this service
	North Pembrokeshire
	Mid Pembrokeshire
	South Pembrokeshire
	Pembrokeshire wide
	West Wales
	Nationally

46.	Would you like to add another service?
	Yes
	No

Service 5

47.	Name of project, activity or service

48.	Operating from (address if different to main address

49.	Description of project, activity or service provided

50.	Project start and finish date
	Start Date
	Finish Date

51.	Target group(s), e.g. children, adults with mental health issues, etc.

52.	Please tick the age group(s)
	0-10
	11-25
	26-49
	50+

	Other

53.	Area served by this service
	North Pembrokeshire
	Mid Pembrokeshire
	South Pembrokeshire
	Pembrokeshire wide
	West Wales
	Nationally

54.	Would you like to add another service?
	Yes
	No

Service 6

55.	Name of project, activity or service

56.	Operating from (address if different to main address

57.	Description of project, activity or service provided

58.	Project start and finish date
	Start Date
	Finish Date

59.	Target group(s), e.g. children, adults with mental health issues, etc.

60.	Please tick the age group(s)
	0-10
	11-25
	26-49
	50+

	Other

61.	Area served by this service
	North Pembrokeshire
	Mid Pembrokeshire
	South Pembrokeshire
	Pembrokeshire wide
	West Wales
	Nationally

Thank you for your time. Please click on the submit button below.