Tollerton Parish Council

Tollerton Parish Council
Request to be Registered as Vulnerable:

Information you provide will be treated as confidential. It is only for use in the event of an emergency, by members of our Community Emergencies Group, and by members of NYC’s Emergency Response Team who may be deployed to the village.
You will be contacted at least annually to check whether you wish to remain on the register.
You can ask to be removed from it at any time by contacting the parish clerk.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail
example@example.com
Any additional information that may be useful (e.g. “wheelchair user”):
Should be Empty: