1. Play provision

Please fill in this short questionnaire by Friday 25 June if your organisation is involved in play provision in Birmingham. The questions are all required. Thank you.

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* 1. Name of the provider -
The main organisation delivering the service:

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* 2. Lead contact:

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* 3. Postal address:

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* 4. Description of your service relating to play:

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* 5. How often do you provide the service (eg holidays, weekly, weekdays):

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* 6. Age range of children and young people benefiting from the service:

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* 7. In which constituency(ies) do you provide your service (ie Edgbaston, Erdington, Hall Green, Hodge Hill, Ladywood, Northfield, Perry Barr, Selly Oak, Sutton Coldfield, Yardley, citywide):

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* 8. Who funds your service?
What is the cost of this service? (optional)

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* 9. Do you wish to be involved in future consultations? Please add any comments you may have.
Thank you for participating in this survey.

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