Pre registration form

If you are aged over 16 years old, but under 18, you can pre-register to join the Anthony Nolan register by filling in the form below. We will email you on your 18th Birthday to remind you to sign up to the register so we can send you a saliva testing kit.

If your contact details change before your 18th Birthday, please email us to let us know.

* Denotes a required field

There are errors with your form, please complete all of the required fields

Title* First name*

Date of birth*

Last name*

House name/number

Postcode

Address 1* Address 3 County

Address 2 Town/City* Postcode*

Mobile telephone (no spaces)*

Email (not school email if possible)*

What prompted you to join?*

I have read the privacy policy*

Please indicate if you are happy for us to contact you via these methods Email SMS