The United Reformed Church (Carmarthen Rd) Caepistyll Street, Swansea. SA1 2BE Contact: unityswansea@gmail.com Web: www.uidswansea.wordpress.com
Member Registration Form Personal Details Title:
First Name: Family Name: Home Address:* Postcode:
Email:
Telephone Number: Where are you from?
Are you getting any money from the Government? Are you: community member
Yes/No
asylum seeker
(please tick)
How did you hear about the Unity in Diversity Group?
Date of Birth:*
Gender:* Male/Female
Member Signature:
NI Number:*
Disability:
Yes / No
Date:
refugee