Neighbourhood Forum Membership Application

Finsbury Park and Neighbourhood Forum has four types of Forum Member:

• Resident Member – a person whose usual residence is within the Neighbourhood Area; • Worker Member – an employee / self-employed person whose usual workplace is within the Neighbourhood Area; • Elected Official Member – a ward councillor, Member of Parliament, or Assembly Member whose constituency forms part of the Neighbourhood Area, and; • Affiliated Organisation – a formally constituted community group that has an interest in the Neighbourhood area

By submitting this application form, you agree to abide by the provisions of and Stroud Green Neighbourhood Forum constitution, available at www.finsburyparkstroudgreen.com.

An asterisk (*) denotes a required field.

Full name* Please list any relevant skills and interests (This question is optional)

I am applying to become a…* (Please choose one)

□ Resident Forum Member □ Worker Forum Member □ Elected Official Forum Member Signature (Optional)

Affiliated Organisations should contact the Membership Secretary for details about becoming a member. FOR USE BY MEMBERSHIP SECRETARY Street address of usual residence or ONLY: workplace* Address is within Neighbourhood Area?

Postcode of usual residence or workplace* □ Yes □ No

Electoral Name of organisation (Worker and Elected ward Official Forum Members only) Date added to Register / / Email address* of Members

Do you agree to your contact details being stored?*

These will only be used for the purposes of preparing a Neighbourhood Plan for Finsbury Park and Stroud Green.

□ Yes □ No

Finsbury Park + Stroud Green, c/o Finsbury Park Trust, 225-229 , LONDON, N4 2DA