Referrals form | The Pankhurst Trust and Manchester Women's Aid

Your name

Your contact number

Your contact email

What is your relationship to the person you are referring?

The name of the person you are making a referral for

The contact number of the person you are making a referral for

The contact email of the person you are making a referral for

The post code of the person you are making a referral for (We can only support those living within the Manchester City Council District. Please use this post code checker Find your local council and if you are not in an Manchester City Council address, please contact the 24-hour National Domestic Abuse Helpline on 0808 2000 247 to find your local services)

Safe time to call between 9am-4pm Mondays to Fridays (these are our working hours)

Please tell us what they need help with?

If you are an agency making a referral for a client, WE CANNOT ACCEPT THIS WITHOUT A REFERRAL FORM. Please email referrals@manchesterwomensaid.org instead and we will send you a different referral form

If you are an agency you need to send us a completed referral form. You can request this form at REFERRALS@MANCHESTERWOMENSAID.ORG or call 0161 660 7999.

*If you are an agency making a referral for a client, WE CANNOT ACCEPT THIS WITHOUT A REFERRAL FORM. Please email referrals@manchesterwomensaid.org instead and we will send you a different referral form*

If you are an agency you need to send us a completed referral form. You can request this form at REFERRALS@MANCHESTERWOMENSAID.ORG or call 0161 660 7999.

Join our mailing list

If you are an agency making a referral for a client, WE CANNOT ACCEPT THIS WITHOUT A REFERRAL FORM. Please email referrals@manchesterwomensaid.org instead and we will send you a different referral form