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Application

 

HTN, Unit 1, Central Depot, Forward Drive,

Harrow HA3 8NT  Phone: 020 8907 9677                   

 

           ……………. < cut here to keep the address > ...................

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?   

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

 

Please return this form to:-                          

HTN, Unit 1,Central Depot, Forward Drive,

Harrow HA3 8NT  

                                                                                                                                                                                  OL1


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