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Hartleneighbours Interest Form
If you are interested in starting your own street support network and would like to talk further please fill out the following
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* Indicates required question
What is your full name?
*
Your answer
What is your full address?
*
Your answer
Please enter a contact number we can call you on?
Your answer
Are you a regular user of any Hartlepool community centres?
You or your family using centre facilites once a week (before the COVID-19 Pandemic)
Yes
No
Clear selection
If you answers yes, which community centre do you use?
*
Thinking about this question before the COVID-19 Pandemic. Please enter other church based or community settings
Kilmarnock Road
Belle Vue Centre
The Annexe
West View Project
Burbank
The Salaam Centre
Don't use any
Other:
Thank you for your time, a member of our team will be in touch
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