Norfolk Coalition of Disabled People (NCODP)

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Associate Membership Application

Associate (individual) membership application form

Please fill in the online form below and send by using the Submit button at the end of the form.

About you

Do you consider yourself a disabled person?
Yes
No

Your Contact Details

Your Name:
Your Address:
Your Postcode:
Your Email address:
Your telephone number:
Your Minicom number:
Your preferred method of contact:

How would you like to recieve our newsletters?

Email Word document (text only)
Email PDF document (with pictures)
Postal
Audio CD
Audio mp3
Audio cassette

We would also like to know if you are involved with any organisations in Norfolk that promotes the interests of disabled people.