Sign-up as a neighborhood watch - Buurtpreventie Wernhoutsburg

Sign up as a neighborhood preventer *

Name *

Voornaam

Achternaam

Email adress *

E-mail

E-mailadres bevestigen

Birthday - Month - Year *

Address *

House number *

House number addition

City *

Zip code *

Question or comment

You want to follow the neighbourhood prevention course?

Yes
No

Do you understand the Dutch language?

The neighbourhood prevention course will be given in Dutch. You must be able to understand the Dutch language in order to successfully complete the course.

I accept the privacy statement *

Yes

I agree that my personal data will be shared with the Neighbourhood prevent group Zundert. *

Yes