Block Membership Application Form

(Min 5 Homes with distributor)

Fees are £5.00 per home. The distributor will receive a 10% discount based on the number of homes registered.

Please follow the numbered steps:

STEP 1: Complete the sections below.

IPHAS are keen to reduce paper waste. If you would like to assist us, please tick the boxes for all/any members happy to receive communications and notifications by email. Obviously we would also need those members' email addresses in order for us to be able to notify them accordingly. Thank You.


Distributor Details

Park Details


Park Name *


* Address  *
Address on Park *
Home Phone Town *
E-mail Address County *
Are You In A Residents' Association? 

Postal Code *
I Am Happy To Receive All Communication By Email 

Member Details

Title Initial


Address on Park

Email Address


For more Member Fields please complete additional forms and enter total number of forms submitted here: *  

*Required Fields

STEP 2: Enter the date.

Today;s Date (DD/MM/YYYY)

STEP 3: Submit the form.

Please send this form to:

The Membership Administrator.

Ken Carroll
19 College Close
Probus, Truro

I enclose cheque or money order made out to IPHAS for