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Join Dial A Ride

If you wish to join Dial - A - Ride please complete and return the form to the address below. A nominal charge is also made for each journey. Please make Cheques payable to 'Newtown Dial - A - Ride'
Name : .................................................................................
Address : .................................................................................
: .................................................................................
Telephone : .................................................................................
Please Select Pensioner Disabled
Date of Birth : .......... / .............. / ...............
Signed : .................................................................................
   
 
 
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