Mend and Tend Registration Form

Mend and Tend is a Community First not-for-profit decorating, repair and gardening service. It is for residents of Gosport who are older/vulnerable and/or have a disability and wish to continue living independently in their own home.

Please complete the application below to use the Mend & Tend service with Community First. The information you supply will help us match the right worker to your needs, and will of course be kept confidential.

Contact Information

Please provide the name and address of the person that will be receiving the service. If you are completing this form for someone else, please add your name and contact details in the next section as the Emergency Contact or Next of Kin.

First Name

Surname

Address

City

County

Post Code

Telephone Number

Mobile Number

Home Ownership Status

Home Owner

Council Tenant

Private Rent

OtherOther

Are there any pets at your property?

If yes, please state what pets.

Have you been in the forces?

Date of Birth

Name of GP Surgery

Emergency Contact Details

City

County

Post Code

Country

Emergency Contact Telephone Number

Emergency Contact Email

Key Safe Details

Please enter your key safe code if you have one

Which service(s) are you interested in?

Gardening

Decorating

Repairs/Odd Jobs

Please supply details of the gardening work required e.g. front/back garden, lawn mowing, weeding, pruning, hedge cutting, overgrown garden, etc. Please note that you are expected to supply your own gardening tools and we do not supply garden waste removal.

Please supply details of the decorating work required e.g. which room, walls, ceilings, wall paper, skirting boards, number of doors, etc.

Please supply details of the handy work required e.g. curtain rails, hand rails, flat pack, fence repairs/painting, gate repairs/painting, tap washer replacement, etc

Do you have your own tools for any garden work that needs doing?

Additional Information

Please supply additional information that will help us match the right worker for your needs.

Do you have any general health issues that prevent you being able to do this work yourself?

Do you have any support needs. For example, hard of hearing, it takes a while to answer the door or if you would like a relative/friend to be first point of contact etc.

Is there anything else you would like to tell us about? Are you completing this form on behalf of someone else?

How did you hear about our services?

If you were referred by an individual or organisation please state their name and/or organisation

Invoicing & Payment

The Mend & Tend annual subscription charge is £60.00. This fee will offer access to gardening, decorating and handy workers until 31st March 2026.

How would you like to receive your invoice?

Email (recommended)

Post

If you would like to receive your invoice by email, please confirm the email address below

How would you like to pay your Invoice?

Direct Debit

By phone

We will be in contact to confirm your details regarding setting up the service. Please note that you pay your worker directly at £13.50 per hour. A receipt should be supplied to you by your worker for this payment.

Please tick this box to confirm you understand

In order to provide a professional, effective and continuous service, we need to keep a record of personal information. This information includes your name and contact details, the person to contact in case of emergency, medical information and information you have shared with us regarding the service(s) you use. All personal information is treated as private and confidential by all staff, volunteers and self-employed workers. It is recorded by staff on a database and/or in a paper file in accordance with the General Data Protection Regulations (GDPR).

There may be times when a member of staff/volunteer/self-employed worker might need to discuss some of your personal details with other agencies, for example, adult services, your GP surgery or the emergency services. We will only do this when it is strictly necessary and will help you. In order to do this, we need your permission below. We review consent when there is a significant change in circumstances; please advise us if you feel that your situation has changed.

You have the right to see any information that we hold about you, and to have your details removed at any time. If you do want your details removed, you will need to be clear about what personal data you want removed and from which particular information file. You need to email the Home Services Manager jayne.smith@cfirst.org.uk and your data will be removed within 3 working days. We may compile statistical information for monitoring purposes but this will never include references to a particular individual.

Required Consent

To place required referrals

To contact Next of Kin

To hold Key Safe or access details

To receive fundraising or other news from GVA

To take photos for marketing use

Thank You

Please submit your form and we will be in contact soon

If you are human, leave this field blank.

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