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Essex County Council will use the information provided on this form only for the purpose you have specified. Information will be treated in accordance with the Data protection Act 1998. See Terms and Conditions

* - required field

Your Details

Your name*: So that we can validate your entry.

Your phone number*: So that we can contact you if we need to.

Your email address*: So that we can contact you if we need to.

Service/Activity

Title/Name*: The title/name of the service or activity.

Description: (shift+enter for a new line); A short description of the service or activity.
Please keep it short but informative. You can always put any further information in the 'Any other information' field below.

Venue

Address: (shift+enter for a new line); The service or activity venue address.
Partial addresses are fine.

Postcode: The service or activity venue postcode.
Full postcode please.

Website URL: (please include the http:// prefix.); The website url of the service or activity if they have one.

Venue notes: (shift+enter for a new line); Any other venue information.

Details

Date(s)/Time(s)/Opening Hours: When can people use the service or activity?

Membership is open to: Who is allowed to take part/join?

Age range: What is the age range of the target audience?

Cost: The cost of the service or activity (if there is one).

Booking info: Is there a booking facility? How are bookings taken?

Waiting list: Is there a waiting list?

Disabled facilities: (ctrl+click to select multiple values, ctrl+click to de-select); If applicable, select the relevant disabled facilities for this service or activity.

Referral method: Is a referral needed to use this service or activity? If so then how is a person referred?

Child Protection policy: (ctrl+click to select multiple values, ctrl+click to de-select); If applicable, select the relevant child protection policy for this service or activity.

Contact

Name: (separate names with a semi-colon); The name of the person(s) who can be contacted about this service or activity.
You can enter more than one name here.

Address: (shift+enter for a new line); The contact address (which may be different from the venue address).

Telephone: (separate telephone numbers with a semi-colon); The telephone number(s) at which the service or activity contact can be reached.
You can enter more than one telephone number here.

Email: (separate addresses with a semi-colon); The email address(s) at which the service or activity contact can be reached.
You can enter more than one email address here.

Any Other Information

Any other information: (shift+enter for a new line); Any other information which may be relevant to this service or activity and which has not already been covered in the description.