Register for a funded place May 2021
This form requires your details for the purpose of your participation in the Uplift at home sessions. Your email address and details will remain confidential and used within the coaching element of the sessions. The form will remain stored in our records. Client safety and integrity are important values to Let's Get Going, we adhere to the GDPR requirements.

This form is to ensure you qualify for a funded place.
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Email *
Your contact number *
Your First Name *
Your Last Name *
Your Date of Birth *
Are you shielding / vulnerable / have long term health conditions ? (Please summarise)
What would you like to address during this course? How do you feel and how do you want to feel?
How did you hear about this course? *
What is your postcode *
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