Print this page

Application

 

                                        HTN

 

            Unit 1, Central Depot, Forward Drive,Harrow HA3 8NT  

                                   Phone: 020 8907 9677                   

 

                    Application to receive the Harrow Talking Newspaper

 Mr  /  Mrs  /  Miss  /  Ms  (please circle one)

 First name: ……………………… Surname:…………………………………..

 

Address: ........................................................................................................

             ...................................................................... Post Code: ……………  

Telephone: ……………....................               Year of Birth  .......................

Are you Registered Blind?  YES  /  NO  or  Are you partially sighted?    YES  /  NO 

Do you need to borrow an audio player from HTN?       YES  /  NO

How did you learn of HTN?  .............................................................................. 

Your details will be held securely in our studio as long as you are a member and will be destroyed within three months if your membership ceases.

Date: …………………..   Signature:.........................................(Yours or on your behalf)

 

Please return this form to:-   

HTN, Unit 1, Central Depot, Forward Drive, Harrow HA3 8NT  

                                                                                                                                                                                  OL1


Previous page: Listeners
Next page: Contact