Form for street outreach/door knocking What kind of sign up is this?*New Friends RdFree lifetime membership (unwaged)Sign up as paying member nowSend email about joiningFirst name*Second nameEmail Phone numberStreet addressPost code*BoroughIslingtonWhat kind of housing do you live in?Renting from a private landlordCouncil homeHousing association homeI own my own homeTemporary accomodationOtherWhat is the name of your landlord?What is the name of your estate agent?Do you have any of the following housing problems at present? Facing eviction Deposit issues Disrepair Overcrowding Rent rise/rent unmanageable Homelessness/access to housing Harrassment Other (please write more details in the next box) Can you make the meeting on Mon 10 September?YesNoMaybeMeeting details: Old Red Lion pub, Monday 10 Sep, 6:45pm for a 7pm startDo you wish to record any more information/notes about this person?Details of this person's housing situation== Consent to store data == We will store your information securely in a database. We will always do our very best to keep the information we hold about you safe and secure. We will never share your data with any third party without asking you first. We will occasionally contact you by email or phone. Does this all sound okay? Tick this box to confirm the person gives their consent to have their data stored and to be contacted Yes ==Add this person to a group/branch?*Friend St/IslingtonEven if you're adding someone as an interested contact, you need to select the branch or group that you're hoping they'll become active with. Name of person signing up this new member/contactWhere are you doing this sign up?*Door knockingStallLRU meeting/eventNon-LRU eventCommentsThis field is for validation purposes and should be left unchanged.