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Irish Community Care Manchester
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Staff member
Existing Contact
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Name of Individual
Type of Individual
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Service User
Volunteer
Trustee
ICCM Staff
Professional
Check For Existing Contact
First Name
Last Name
Gender
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Male
Other
Birth Date
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Phone Number
Demographics
Ethnicity
- None -
White - British
White- Irish
White- Irish Traveller
Other White
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Asian or Asian British - Bangladeshi
Chinese
Black or Black British - Caribbean
Black or Black British - African
Black Irish
Other Black
Mixed - White & Black Caribbean
Mixed - White & Black African
Mixed Asian
Other Mixed
Age Group
- None -
18-24
25-34
35-44
45-54
55-64
65-74
75-84
85+
Extended Details
Irish Status
- None -
Irish Born
Irish Descent
Naturalisation
No
Irish Citizen
Yes
No
Applied (FBR)
Referral/Enquiry Details
Date
*
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2025
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Method of Contact
*
- Select -
Phone Call
Email
Office Drop In
Social Media
Other
Reason for Referral/Enquiry
*
- Select -
General Enquiry
Request for Support
Passport Enquiry
Follow up Enquiry
IT Support
Lunch Group Enquiry
Volunteering Enquiry
Befriending Enquiry
Other
Details
Details
Outcome
*
A&I Appointment Made
Referral submitted to A&S
Message passed to relevant staff member
No Further action required
Referral Signposted
Referral Declined
Placed on A&I Waiting List
Referral Signposted To
Reason for Referral Decline
Time spent
min.
