Membership Application Form

Please complete as much of this form as possible. Information will only be used for purposes connected with Haringey Families.

Contact details:
Please provide your contact details. The newsletter will be sent to your postal address. Enter an email address to access the Members' Area of the website and to receive membership notifications.
First name:
*
Surname:
*
Other surname:
Address:
*
Town/County:
*
Postcode:
*
Tel:
Mobile:
Email:
* Required fields
Membership:
Please select a subscription from the list below. Subscriptions expire 30th April of the expiry year. A 50% reduction for the one year rate applies from October. Subscriptions for the new membership year become available in March.
£12.50One Year (2010-2011)
£22.50Two Years (2010-2012)
£30.00Three Years (2010-2013)
£6.25One Year (2010-2011) (Concessionary rate*)
* Documentary evidence may be required
Events:
We can only continue to run events with the help of our members. Please tick any might would be able to help with, or if you are interested in joining the committee in the future.
Summer Fun DayHalloween PartyNearly New Sales
Toddler GroupEaster PartyCommittee
Newsletter:
Could you contribute an article for our newsletter? Do you have a suggestion for an article? It could be on any subject you think may interest other members. Please give an outline below, or indicate 'Yes' for the moment and fill in the details later, when you log in.
Family Profile:
Please indicate the years in which your children were born (e.g. 1999, 2001, 2004). When combined across all members, this information gives us an idea of the age profile of Haringey Families children, and helps us to better target our activities and events.
Year of birth:
Child 1:
Child 2:
Child 3:
Child 4:
Child 5:
Our publicity:
How did you first hear about Haringey Families?
FriendHealth visitorNotice in shop
Notice in libraryInternet searchLocal paper
Other
Please sign:
Date:

If you are paying by cheque in a name different from the one you are using above, please provide the name of the account holder so that we can trace if the cheque is returned.

The completed form, together with your cheque or postal order made payable to Haringey Families, should be returned to

Membership Secretary
Louise Briggs
8 Lyttleton Road
LONDON
N8 0QB

Thank you!