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* 1. ORGANISATION NAME:

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* 2. CONTACT NAME:

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* 3. CONTACT EMAIL ADDRESS:

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* 4. Please list below the services you provide. Please include any projects or self-help groups you support.

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* 5. Which areas do your services cover?

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* 6. How are people referred into your Service?

THANK YOU FOR TAKING THE TIME TO COMPLETE THIS QUESTIONNAIRE

Your response will help NDVA update our records of members service provision

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