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 as well.

Select Gender (optional)
MaleFemaleLGBT+Prefer not to say

Select Age Bracket (required)
18-2425-3435-4445-5455-6465-7475 and overPrefer not to say

Do you have any disabilities? (optional)
YesNoPrefer not to say

Ethnic origin: I would describe myself as – optionally PLEASE TICK in one of the following five categories

A White: British, English, Scottish, Welsh, Northern IrishB Mixed: White and Black Caribbean, White and Black African, White and AsianC Asian, Asian British: Indian, Pakistani, BangladeshiD Black, Black British: Caribbean, AfricanE Chinese, Chinese British: ChineseOther, please specify:

How did you hear about us? (required)
Through a local Residents AssociationOther local organisation such as Friends of Wimbledon Town Centre, Wimbledon SocietySocial media such as Facebook, Instagram or Other social mediaFrom a websiteNational or Local press (Wimbledon Times/Time & Leisure), radio or televisionLocal event/stall in the townWord of mouth, Close friend or a neighbourDon’t knowOther, (Write in)

Any additional information or questions for us?

Data Protection
All information supplied will be held by Wimbledon Neighbourhood Planning Group and will remain secure and confidential. This data will only be held and used for the 'legitimate purposes' of the Wimbledon Neighbourhood Planning Group. 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.

Privacy Policy
You have read and understood the Privacy Policy (opens in a new window) You must do this before proceeding.

Δ