Join Neighbourhood Watch
 
 
  Title:
     
 
   
  Please complete the fields below:
     
  First Name:
  Surname:
  ID No:
  Cell no:
  E-mail:
  Language:
     
   
  Residential Address : ( please include street number and name, or appt number and complex name, where applicable )
   
  Do you live:
     
  In a house
  In a flat or apartment
   
 
     
  House Number:
     
  Street Name:
     
 
   
  Leisure Bay / Glenmore:
     
 
   
  Patrolling Preferences: Are you available for patrolling?
     
  Night Patrol
  Daylight
  No
   
  Night Patrol - do you have any preferences? (We will try to accommodate you where possible).
 
   
  Daylight Patrol - Please tick when you would be available
     
  Weekly
  Fortnightly
  Monthly
  Monday
  Tuesday
  Wednesday
  Thursday
  Friday
  Saturday
  Sunday
  Preferred time of day
     
  Partner Preferred:
     
  Yes
  No
   
  Name of Preferred Partner:
 
   
  How would you like to get involved? Are you prepared to assist with the following:
     
  Recruiting members for Neighbourhood Watch
  Making a financial contribution towords radio and other equipment purchase
  Making a regular monthly donation towards the operating costs of Neighbourhood Watch
  Providing assistance in an Administrative capacity
  Providing assistance for Fund Raising of Social Events
     
  Other skills that you have:
   
 
   
  Your property:
     
  Permanent Resident
  Holiday Home
  Vacant Stand
   
  Debit order:
     
  Please complete the debit order form
   
 
Security Check:   


 
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