2.-Welcome-Card
 

Welcome!

Please let us know how we can help you more by filling in the fields below.

 
First Name:
Surname:
Address: Number and Street:
Address: Area:
Address: Town/City:
Address: County:
Address: Postcode:
Address: Country:
Home phone:
Mobile:
Email Address:
 
Age Range:     11-18
19-30
31-50
50+
   
Would you like us to :-  
Give you a call for support
Help you find a small group or community
Send you information of upcoming conferences and events
 
How did you come to get to
know about us today?
 
Anything else you would like us to know
or that we can help you with
   
I consent to my personal information being stored and used by Bethshan North East for administration purposes. I understand that I can withdraw my consent at any time. Further information is available in the privacy policy on our website
 
I consent to Bethshan North East contacting me with updates and information regarding upcoming events, conferences and training days that we think may be of interest to you. I understand that I can withdraw this consent at any time.