Join The LINk

By completing these fields you will become a LINk Member, and you will be informed of relevant LINk activities.

Your details will be held on a database and stored in accordance with the Data Protection Act 1998.

Title: *

Forename: *

Surname: *

Address: *

Telephone number: *

Email address:

What area of the LINk are you interested in? (Choose all those that apply) *

Disability Adults & Older People Young People

Mental Health Carers

How would you like us to keep in contact? (Choose all those that apply) *

Telephone Email Post

I would like to be active in the work of the link and work with other members.

I would like to receive information and stay informed.

Equal Opportunities

The following information will only be used to monitor our own performance, and it will not be shared with any other people or organisations. It will be processed and stored in accordance with the Data Protection Act 1998.

You do not have to complete this section in order to be involved, but it will help us to monitor our performance if you do so.

Date of Birth:

Gender:

Ethnic Origin:

Religion:

Do you consider yourself to have a disability?

Yes No

Are you a carer?

Yes No

* Indicates a required field.

Call us on: 0161 622 5700