cinderhill liaison group form

Cinderhill Liason Group Registration form

Name:

Address:

Postcode:

Home Tel:

Mobile Tel:

email:

Date of Birth

Profession/Job

How long have you lived in this community? (years)

Have you been involved in the opposition group?

yesno

Have you been involved in the Banks' Liaison group?

yesno

Why are you interested in being part of our liason group

Are you able to attend meetings:

weekdays

Evenings

weekends