Consent and Preferences

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* 1. Do you consent for MHCN to store details you provide in this membership form in a confidential database accessed only by authorised staff of MHCN?

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* 2. What is your name?

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* 3. What is your postcode?

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* 4. What resources, opportunities, and information would you like us to contact you about? (please check all that interest you)

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* 5. I want to be contacted by MHCN via (please select one only):

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