HAGGERSTON POOL COMMUNITY TRUST

Membership Application

Please enrol me to the membership of the Haggerston Pool Community Trust

Name ………………………………………………………………..

Address ………………………………………………………………..

………………………………………………………………..

Postcode…….………..

Tel. No. (Work) ……………………………

Tel. No. (Home) ……………………………

Mobile ……………………………

E-mail …………………………….

Representing Self

Group Name of Group……………………………..…..

All personal details will be kept for the purposes of the Haggerston Pool Community Trust activities only. Individual names will not be published

Organisations : we may need to use the name of the group you represent in publicity material. Please tick this box if you do not wish your group name to be used in Haggerston Pool Community Trust publicity material

Signed……………………………………………. Date…………..

Please return to:-

Liz Hughes

Haggerston Pool Community Trust

c/o HCD

62 Beechwood RoadLondon E8 3DY

pool@hced.co.uk