Take a Seat - Business Registration Form

Bury Council Take a Seat

Please provide all required details to register your business with us
Name of person completing the form*

First NameLast Name
Business Name*
Contact Number*

Area CodePhone Number
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of Business*
Business
Other
Please confirm what you are able to offer*

Somewhere for people to sitA glass of waterAccess to toilet facilitiesA hot drinkSomething else
If you have selected 'Something else' above, please specify here
Do you require one of our ‘Age Friendly’ chairs?

Yes pleaseNo thank you
I agree to provide a chair and to display the window sticker to promote that my business is ‘Age Friendly’ and follow the Take a Seat (TAS) guidance provided.*

AgreeDisagree
I agree for my data to be stored by Public Health, Bury Council for the purpose of the TAS scheme and for my business to be added to the Bury Directory. Please view our Privacy Policy Statement.*

AgreeDisagree
Please tick Agree if you would like to receive information regarding Age Friendly communities, i.e.invitations to future training/workshops and information.*

AgreeDisagree
Should be Empty:

Bury Council Take a Seat