Home > Self Referral

Refer yourself to Church on the Street

Please use the form below to refer yourself to one of our groups or services.

We are open Tue, Wed & Thu, 9.00am – 3.00pm (Wed 1-3pm is women only).
See What’s On each week

Bethesda Church, Bethesda St, Burnley BB11 1PR (behind M&S).
See location

Self Referral

"*" indicates required fields

NB: If you are referring someone else click here
DD slash MM slash YYYY
(Type "nfa" if homeless)
I would like to refer myself to:*
Consent*