North Staffs Carers - Order Resources

To request resources please fill out the form below. We will send the requested documents as quickly as possible & add you to our mailing list if indicated.

We regret we cannot accept applications without a valid Name, E-mail address, Address and Telephone number.

If you prefer you can send the details requested below via fax: 01782 330792 or post: North Staffs Carers Association, Carers Centre, 1 Duke Street, Fenton, Stoke-on-Trent, ST4 3NR.

Order Form

Please send me:
A Carers Information Pack:
A Carer Self-Health Check:
A Sample Issue of the CLAN newsletter:
Please add me to the Mail list for CLAN
Please send me a New Wallet & Carers Card

Your name:

Address Line 1:
Address Line 2:
Town/City:
Postcode:
County:

Day Tel. No.:
Fax:

E-Mail:

I am a Carer:
I am a Professional interested in Carers:
Other:

How did you find out about the web site? (If you found out about us at your GP surgery, please tell us which surgery):