BLF MEMBERS REGISTRATION FORM
Thank you for taking interest in our Charity. Please use this form to register for access to all our FREE SERVICES. Find more here:
Health & Wellness Programme
Basic Education Programme
Employment Support Programme
General Support Service
Date of Birth
Please enter the date of birth in this format DD/MM/YYYY eg: 30/09/1990
Please enter your full address
Please enter your full post code
ASIAN: British, Indian, Pakistani, Bangladeshi or Any other Asian background || BLACK: African, British, Caribbean or Any other Black background. || MIXED: White and Black (African, Caribbean or Other), White and (Asian or Other), Black and Asian or Any other Mixed background || ORIENTAL: British, Chinese, Japanese or Any other Oriental background || WHITE: British, Irish, Scottish or Any other White background.
Are you a single parent or from a single parent household?
Are you currently a single parent or was your parent a single parent?
What best describes your current family structure?
Single parent mother
Single parent father
Dependant of a single parent
Two parent family
Couple without children
How many children/dependants do you have?
5 or more
What is your current employment status?
Working 15 hours or less per week
Working 16 to 29 hours per week
Working 30 hours or more per week
What is your usual household income before tax, including working taxcredits and benefits?
Less than 10,000
10,000 to 19,999
20,000 to 29,999
30,000 to 39,999
40,000 and over
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