Cranbrook & District Probus Club : Personal Data Collection and Consent Form
The Committee would like to ensure that, before a new edition of the "Yellow Book" goes to print, we have not only up-to-date information for each member but also explicit permission to reproduce that information in the Yellow Book and/or online in the secure "Members only" section of the web site. We would therefore be very grateful if you could complete the form below. Please note that a print{ed|able} version of the form is available on request from our Hon. Sec'y, Roy Dunstall, for any member who would prefer to provide the information in hardcopy form. Thank you very much in advance for your co-operation in this data-gathering exercise, which is much appreciated.
I,
of
Residential address inc. postcode (max. 5 lines / 175 characters) :
with telephone number :
and/or e-mail address :
hereby give permission for the details supplied herein, and only those details, to appear in the Cranbrook and District Probus Club Members' Handbook and/or in the secure password-protected Members' Only area of the Cranbrook and District Probus Club web site as I have indicated. I understand that I am not obliged to provide any details other than my name, address, telephone number and/or e-mail address (these are required to ensure that the Committee can communicate with all members), and I am willing for any details that I elect to provide additional to these to appear
You may include my name :
, my address :
, my telephone number :
and/or my e-mail address :
My preferred medium for communication is :