Solidarity Meals

KCINA TA MARTA – SOLIDARITY MEALS

This section is about the Professional referring a client/s to Solidarity Meals

The Referring person will be our direct contact, and the one who we will contact when a review of the case is due and to whom the delivery note will be addressed to. Should this need to change an email to [email protected] will need to be sent to provide the new information

Name & Surname(Required)

of professional referring

Profession(Required)

Warrant No / Role & Parish/Agency(Required)

Email(Required)

Mobile(Required)

Parish/Agency(Required)

This Section will ask for details pertaining to the beneficiary/beneficiaries

Name & Surname(Required)

Beneficiary Name & Surame

Address(Required)

Street Address Address Line 2 Locality Postcode

Mobile – (please include all numbers to contact beneficiary as w will not be able to deliver unless they speak to the deliveing volunteer)(Required)

Amount of Solidarity Meals per week to be delivered to household (max 7 per week/per person)(Required)

ID Card Number/Passport Number

Any Dietary Needs

Other Details re Service

It is important that the beneficiary is informed: That name address and details incl dietary needs will be provided to the delivering volunteer To makes sure to have the freezing space for the weekly amount of meal requested Deliveries are held once weekly Whilst volunteers will do their utmost to deliver a varied menu sometimes they might not be able to provide a different meal for every day of the week

Payment amounts(Required)

Free solidarity Meals

1€ per meal

3€ per mral

Who will pay(Required)

Invoice to be issued to beneficiary

Invoice to be issued to my office

The meals are needed for free

Anything else you want to tell us

Signature

For Office Use

Volunteer Delivering

Mobile of volunteer delivering