Simply fill in the registration form below and go to the ShopMobility unit to countersign the registration agreement.
Or you can download the registration form, print it, fill it out and go to the ShopMobility unit to countersign the registration agreement.
As part of the registration, two forms of identification are required which should show name and current address, such as a utility bill, passport and/or driving licence.
In the Ealing Broadway Shopping Centre multi-storey car park. There are disabled parking bays on the first floor. The car park can be reached from either Grove Road, via St Mary’s Road (opposite Ealing Green), or Windsor Road, via Ealing Common.
Please contact the ShopMobility office for further details.
Please phone 020 8579 1724 or 020 8840 6977 to book your session.
Please contact Katie Peploe, the manager at Ealing ShopMobility, on the above telephone numbers or email:firstname.lastname@example.org
If you use this online registration form, we will contact you, on receipt of this form. You will be required to visit the ShopMobility unit in the Ealing Broadway Shopping Centre car park in order to countersign and complete your registration.