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Members Sign-up Form

Thank you for your interest in joining Lucy's Pantry. To apply, please fill out the form below. Once your application is received, one of our team members will review it and contact you with an update on your approval status and the next steps.

Are you referring yourself, or is this a referral from an organisation?
Self-referral
Organisational referral

If you are referring yourself, please tick 'Self-referral' then proceed to fill out your personal details below. If you are an organisation referring an individual, please tick the "Organisational Referral" option, provide your organisation’s name and contact email, and then complete the details of the person you are referring.

Gender
Age
Ethnicity
Do you consider yourself to have a disability
Yes
No
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