Wiltshire Warm Spaces

We are developing an interactive Wiltshire Warm Spaces map that will appear on the Wiltshire Council website to enable residents to easily identify local warm and welcoming spaces.

Our aspiration is that Wiltshire warm spaces will be:

·Welcoming, inclusive, and open to the public
·Safe with appropriate safeguarding, insurance, and all appropriate policies in place
·Non-judgemental, where everyone is treated equally, with dignity and respect
·No cost or low cost to attendees

We’d be very grateful if you could please share the details of your warm space by completing the form below. Thank you for your support.

Q1	What is the name of your organisation?

Q2	What is the address of your Warm Space?
	First line:

	Second line;

	Town/Village:

	Postcode:

Q3	What is the contact telephone number?

Q4	What is the contact email address?

Q5	If you have one, what is your website address?

Q6	Who is the best point of contact for your warm space?
	First name:

	Surname:

Q7	When is your warm space open to the public? Please state day(s), then times e.g. Monday and Tuesday 2pm - 5pm

If required, can your warm space provide cost of living information, advice and signposting to attendees?

Yes

Not sure. Would welcome a further discussion with Wiltshire Council about this.

Would your staff or volunteers wish to attend an online Warm and Safe Wiltshire www.warmandsafewiltshire.org.uk training session? Warm and Safe Wiltshire provides energy efficiency advice on a wide range of topics including fuel debt, measures to make your home warmer and grant availability.

Yes

Q11	If other, please state

Q12

Do you offer translation services?

Yes

Q13	If yes, please tell us what languages and / or if you offer British Sign Language?

Q14

Is your Warm Space within a five-minute walk of a bus stop?

Yes

Q15	If yes, please advise of the associated bus number(s)

There is an expectation that the basic offer of a Warm Space is free of charge.

Q16

Please provide details here of any associated costs of attending.

No, we will not ask for any contribution

Yes, we ask attendees to donate what they can afford

Yes, there is a set fee (please enter amount)

Q17	If there is a set fee, please state the amount:

Wiltshire Council would like to publish the information you have supplied about your Warm Space on our website www.wiltshire.gov.uk and promote it through our e-newsletters and social media.

Q18

Please confirm that you give consent for this information to be published, including the contact name, telephone number, email address and website address supplied?

I give consent

Q19

Please confirm that your organisation has an appropriate and current safeguarding policy in place to support your role as a Warm Space.

I confirm

Thank you for completing this form