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Nantwich Buddies Registration Form

To register, please take the time to fill out the information below.

First Name

Last Name

Email

Phone

Address 1

Town

Home Phone (optional)

Address 2

County

Postcode

Do you have a current DBS check?

Yes - Basic

Yes - Standard

Yes - Enhanced

No

Don't know

If yes, please provide your DBS number here:

How old are you?

16 - 17

18 - 24

25 - 35

35 - 44

45 - 54

55 - 64

over 65

Prefer not to say

Are you currently?

Full time employed & working

Full time employed & furloughed

Part-time employed & working

Part-time employed & furloughed

Self-Employed

Student (16 -18)

Student (over 18)

Retired

Unemployed

Other

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Regents Park, 129 London Road,

Nantwich, Cheshire,

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