Enquiry Form

1) Please take a moment to tell us about yourself

Your First Name    
Your Last Name     
Address            
Street             
Town               
County             
Post Code          
Telephone          
EMail              

Age Group

16 to 18 19 to 25 26 to 45 46 to 65 Over 65

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2) Please indicate your interests

• Tick all that apply
  

   Working Weekends
   Residential Work Camps
   Catering
   Administration
   Fund-raising
   Sales
   100 Club
   Other (please specify): 

3) Please tell us how you heard of Kescrg

Recommendation Via the Internet Other Canal Group Via the Waterways Press Duke of Edinburgh Award Other

4) Please indicate previous experience

• Previous Canal Working Party Experience:
  Work Camps Working Parties Other (please specify):

• How many working parties have you attended in the past twelve months ?
  None 1 - 2 3 - 6 More than 6

• Are you a member of another Waterways Group
  Yes No
• If yes please provide details

• Would you like to receive a phone call to obtain additional information ?
  Yes No

5) Please provide details of your enquiry

Thank you for enquiring about Kescrg!

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