Information Input Form

Information Input Form

Please tell The Family Hub what is happening in your Service
By providing information on service and activities you are giving parents access to accurate information via The Family Hub website and our Telephone Service. As the system becomes more well known Service/Activity Providers will be given an individual user id and password to be able to log on themselves and update the activities that they are offering.

Any problems with this form or to provide a Service provider with a user id and password please contact The Family Hub on 0113 2474386 or e-mail us at family.hub@leeds.gov.uk

The information we are asking for is split into 3 sections:

Personal Details is contact details for yourself.

Service Detail is information on the Organisation (Employer) running an Activity eg a Member from Leeds Womens Aid are running a drop in service at a Childrens Centre. The service details will be Leeds Womens Aid contact details.

Activity details will be Women's Drop in with the Children's Centre as the activity venue.

Personal Details

First Name

Surname

Phone Number

E-mail Address

Service Details

Service Name

	Service Address
	Building Name/No
	Streeet
	Area
	City
	Postcode

Contact Phone Number

E-mail Address

Website URL

Activity Details

Activity Name

	Venue Address
	Building Name/No
	Streeet
	Area
	City
	Postcode
	Wedge (If Known)

	Contact Phone Number for the public

	E-mail Address for the public

	Website URL for the public

	Period Running

	If running for a specific school holiday, please state which?

	Please state days and times running? (eg monday 2pm-5pm or runs 3rd friday of each month 1pm-3pm etc)

	Description

Are the staff running this activity CRB Checked?

Yes

	If no, please state, if any, name of other Safety Awards staff have in place?

Can this information be displayed on The Family Hub Website

Yes

Is this Activity a Family Support / Parenting Service?

Yes

If you wish to give us details of more than one service/activity running then please submit this form and open a new form as the first one and submit again. You can submit as many forms as you need to.

Thank you for your time