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Group Coordinators' "Green" Form

Please would you fill in the information about your Group below. When you click on 'Submit' at the end the information will be emailed to the General Coordinator. If your Form does not go then check to make sure you have filled in all the required fields.

Required Fields are marked with an asterisk

Group Please fill in *

Parent Group Please select a valid item.Please select a Parent Group. *

Coordinator's Title Please fill in

Forename Please fill in. *

Surname Please fill in.Exceeded maximum number of characters. *

Membership Number Please fill in.Invalid format. *

Address line 1 Please fill in. *

Address line 2 Please fill in. *

Post Code Please fill in. *

Telephone Please fill in. *

Your Email Address or the email address of the contact person for your Group I need to get back to you

Deputy's Title Please fill in.

Deputy's Forename Please fill in.

Deputy's Surname Please fill in.

Deputy's Membership Number Invalid format.

Deputy's Address line 1

Deputy's Address line 2

Deputy's Post Code

Deputy's Telephone Number

Deputy's Email Address Invalid format.

Tutor's Title

Tutor's Forename

Tutor's Surname

Tutor's Membership Number Invalid format.

Tutor's Address line 1

Tutor's Address line 2

Tutor's Post Code

Tutor's Telephone Number

Time and Day Please fill in. *

Place Please fill in.* Area Please fill in. *

Rent and for what period *

Charge and how often such as weekly/per session etc Please fill in. *

Maximum numbers Please fill in.*

Number on roll Please fill in* Number on waiting list Please fill in. *

Vacancies Please select a valid item. *

Access Code Please select a valid item. *

MH

Member’s Home - access variable

A*

Public Venue - meeting is fully accessible, including a hearing loop

A

Public Venue - meeting is physically accessible, but does not include a hearing loop

X

Public Venue - meeting access is limited.

Equipment held Please fill in.

Details *
A value is required.

If this Form does not go make sure the required Fields are filled in.