How-to-join form

Application to receive the Harrow Talking Newspaper on memory stick.

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:- Harrow Talking Newspaper, Civic 5, Station Road, Harrow HA1 2XY