SAFE - MEMBERSHIP APPLICATION

The information requested on this form is very important for SAFE to maintain its credibility, so please complete all sections. All information will remain confidential. Print off and mail to the address below with your remittance.
Check box (one only) membership type:
[  ] Citizen (Private Citizens)
[  ] Professional (Active or retired police or military)
[  ] Associate (civilians in police or military)
[  ] Private Professional (private security or investigation)
Please list any other groups you are a member of:
Check appropriate boxes:
[  ] I have been a victim of violent crime
[  ] A family member or friend has been a victim of violent crime
[  ] I have used a firearm in self defence on duty
[  ] I have used a firearm in self defence off duty or civilian use
[  ] I have discharged a firearm in self-defence
[  ] I have used items other than firearms for self defence (irritant sprays etc)
[  ] I have used force to prevent or repel crime
Name:
 
Address:
 
 
 
City:
 
County:
 
Postcode:
 
Phone:
 
Fax:
 
Email:
 
Occupation:
 
MP's name:
 
Party:
 

PLEASE MAKE CHEQUE PAYABLE TO:
`SAFE GROUP'
£15 Annual Individual, £25 Annual Family

SAFE, PO BOX 104, Hampton, Middlesex, TW12 1QT