REGISTER

To take advantage of the benefits London Connected has to offer please register using the form below.

We understand the importance or maintaining and protecting your privacy and will not sell or rent your personally identifiable information to anyone.

The information you provide will be kept confidential and will be used to support your relationship with London Connected. From time to time we may use this information to provide you with relevant information we think would be of particular interest.

Please note you need to be a resident of a London borough in order to register with London Connected. If you are not a resident of a London borough your membership will not be approved.

Registration form

1. Personal details:
First Name *	Last Name *
Gender *	Date of Birth *

Address *
Post Code *
Telephone *	Mobile

Email *	Confirm Email *
Choose a Password *	Confirm Password *

2. Under the definition in the 1995 Disability Discrimination Act, do you consider yourself to be disabled? (A physical or mental impairment, whick has a substantial and long-term adverse effect on the ability to carry out day to day activities). E.g. visual and hearing impairments, dislexia, multiple sclerosis, cancer, HiV, etc... *


3. Please select which of the following best describes you:
Ethnic Background *
If Other

Employment Status *
If Other

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