Part D Service User Profile – D1 In which localities will you be delivering services? – Please tick all that apply. If you provide a citywide service, please tick the citywide box and leave all others blank. Assessor use only OR Citywide D2 Which group(s) of citizens will be specifically targeted by your proposal? – Please tick all that apply. People with mental People aged under 18 Men health issues People aged 18 - 59 Women People with addictions Transgender, People with learning People aged 60 - 75 intersex and disabilities people Lesbian, gay, People with physical People aged over 75 bisexual People disabilities People from minority People who are ethnic communities unpaid carers
Part D – Service User Profile D1 – In which localities will you be delivering services? Please tick all that apply. If you provide a citywide service, please tick the citywide box and leave all others blank. Assessor use only OR Citywide D2 – Which group(s) of citizens will be specifically targeted by your proposal? Please tick all that apply. People aged under 18 Men People with mental health issues People aged 18 - 59 Women People with addictions People aged 60 - 75 Transgender, intersex and people People with learning disabilities People aged over 75 Lesbian, gay, bisexual People People with physical disabilities People from minority ethnic communities People who are unpaid carers
SMALL-Application-Form-digital.docx