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Membership Form

* your home address, or your work address if you are not an Islington resident.

I Declare that the following apply to me (Please Tick all that apply)

I understand that, by becoming a member of Disability Action in Islington, in the event of the company becoming insolvent I will be liable for an amount not exceeding £10.

Thank you for applying to being a member, we will get back to you soon!