Form for street outreach/door knocking Basic infoWhat kind of sign up is this?* Set up payment later Paying member Free membership for unwaged person Just collect contact details First name* Second name* Email* Please do not enter a dummy entry like 'noemail@gmail.com'. Please enter phone number if member doesn't have an email address. Phone number* Borough*Select the London borough that you live inBarking and DagenhamBarnetBexleyBrentBromleyCamdenCity of LondonCroydonEalingEnfieldGreenwichHackneyHammersmith and FulhamHaringeyHarrowHaveringHillingdonHounslowIslingtonKensington and ChelseaKingston upon ThamesLambethLewishamMertonNewhamRedbridgeRichmond upon ThamesSouthwarkSuttonTower HamletsWaltham ForestWandsworthWestminsterOutside of LondonPost code* Further infoStreet address We need this to send you a membership pack! What kind of housing do you live in?Renting from a private landlordCouncil homeHousing association homeI own my own homeTemporary accomodationOtherDo you know the name of your landlord? We support each other with our housing issues. Do you have any problems with your housing you'd like to talk to other members about? Facing eviction Rent debt Deposit issues Disrepair Overcrowding Rent rise/rent unmanageable Homelessness/access to housing Harrassment Other (please write more details in the next box) Give details in the box below. If this person is signing up as a member, someone will try to give them a call to share basic renters rights info and invite them to a meeting. Notes for person filling out this formName of person signing up this new member/contact* Is this person a priority to follow up with? Why?If you think we should follow up with this person about the housing issues they're facing, please give details about the issue they're facing What are the main issues this person cares about?What would they like to change about the housing system? Where are you doing this sign up? Stall Door knocking LRU meeting/event Non-LRU event Add this person to a local group or branch? Hackney Newham & Leytonstone Lewisham Tower Hamlets Brent Haringey Camden DotDotDot Guardians If this person lives outside your borough/branch area but you want them to get updates and calls from your branch, tick one of the boxes belowTick this box to add this person to the Disability Justice caucus Yes Tick this box to add this person to the Spanish group/Sindicato de Inquilinxs de Londres? Yes CommentsThis field is for validation purposes and should be left unchanged.