West Middlesbrough Neighbourhood Trust

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Welcome to West Middlesbrough Neighbourhood Trust - Working with the Community...........News Flash! WMNT Launch a New Scheme - "UChoose". See below for details.........

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Membership Form

First Name
Surname
Title
Sex
Address


Post Code
Email
Phone Number
Age Group	18-25	26-40
	41-55	55 or over
Number of other members in the household
No. of adults
No. of children
What is your ethnic group?
White
	British
	Irish
	Other
Mixed
	White and Black Caribbean
	White and Black African
	White and Asian
	Other
Asian or Asian British
	Indian
	Pakistani
	Bangladeshi
	Other
Black or Black British
	Caribbean
	African
	Other
Chinese or other ethnic group
	Chinese
	Other
If you are interested in joining our residents panel, please tick here and a member of staff will contact you.
In order to proceed you must read the WMNT code of conduct available here. Please tick hereto confirm you have read and understood this
In the event of WMNT being wound up, the liability of a member is limited to £1 (one pound)

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