First Name (required)
Last Name (required)
Select Member type - tick any that apply (required)
1. Individual who lives in the area2. Individual who works in the area, whether for business, or otherwise3. Community organisation that operates in the area, through their duly appointed representatives4. Business, educational establishment or other entity that operates in the area, through their duly appointed representatives5. Individual who is an elected member of Merton Council, any part of whose area falls within the Area, who shall be ex officio members6. Individual who has a material and ongoing environmental, social, cultural, or economic interest in the Area.
Your Email (required)
Postal Address (Home, Employment or Community Group)
Your Street Name and Number (required)
Your Town Or City (required)
Your PostCode (required)
Your telephone number (Optional)
For additional details which will help us ensure that the neighbourhood forum represents all people in the neighbourhood please fill in this information (required) as well.
Which of the following describes how you think of yourself
MaleFemaleIn another wayPrefer not to say
Select Age Bracket
18-2425-3435-4445-5455-6465-7475 and overPrefer not to say
Do you have any disabilities?
YesNoPrefer not to say
Which of these ethnic backgrounds do you consider yourself to belong to?
A White: British, English, Scottish, Welsh, Northern Irish, Irish, any other white backgroundB Mixed: White and Black Caribbean, White and Black African, White and Asian, any other mixed ethnic backgroundC Asian, Asian British: Indian, Pakistani, Bangladeshi, any other Asian backgroundD Black, Black British: Caribbean, African, any other African/Caribbean backgroundE Chinese, Chinese British: ChinesePrefer not to say
How did you hear about us?
Through a local Residents AssociationOther local organisation such as Friends of Wimbledon Town Centre, Wimbledon SocietySocial media such as Facebook, Instagram or Other social mediaLocal press (Wimbledon Times/Time & Leisure), radio or televisionLove Wimbledon or other business interest groupLocal event/stall in the townPosting on NextDoorWord of mouth, friend or a neighbourDon’t knowOther, (Write in)
Any additional (Optional) information or questions for us?
All information supplied will be held by PlanWimbledon and will remain secure and confidential. This data will only be held and used for the 'legitimate purposes' of PlanWimbledon. The ‘lawful basis’ for this data processing is the ‘explicit consent’ of the member in question. We will use this information to inform members of the activities of the group and to analyse the data for the purposes of submitting an application to become a designated Neighbourhood Forum under UK law.
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