New Client - South Westminster Legal Advice Centre

First name

Last name

First line of address

City

Post code

Email

if do not have an email address, type do not have an email

Telephone

I confirm that I authorise SWLAC to communicate with me using the above details

What is your gender/gender identification?

I prefer to describe myself as

Age

Do you consider yourself to have a disability?

If Yes are you registered disabled?

What is the highest level of education completed by you?

Which of the following best describes your present Occupational Status?

Are you a parent/guardian of a child or children under 18?

If Yes Please provide the Age(s) of your child(ren)

If you have children, are they eligible for free school dinners?

Is your household headed by a single parent?

Do you face challenges in meeting basic needs, such as food, warmth, housing, and other essential expenses?

Please choose one option that most accurately describes your ethnic group or background

If other, please describe

My issue/problem is mainly concerned with

Please provide a Brief overview of the issue - max 200 words

New Client Appointment Form