Membership Form

Please answer all questions to submit your registration. 

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* 1. Contact details

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* 2. Would you like to be added to Headway Teesside's mailing list?

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* 3. What is your preferred method of contact?

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* 4. How have you been affected by Acquired Brain Injury?

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* 5. How did you hear about Headway Teesside?

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* 6. What do you hope Headway Teesside can help you with?

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* 7. We hold optional fortnightly drop-in meetings on Zoom. Generally, are you able to join us on either the second Wednesday of the month at 1pm, or the fourth Wednesday of the month at 11am?

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* 8. Is there anything you would like to tell us?

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