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Executive Committee Members

Affiliated Members

Applying For Membership

Guidance Notes

 

Application For Affiliation

 
       Name & Address of Organisation
name
address
 
postcode: 
tel: 
fax: 
e-mail: 
minicom: 
 
   Name & Status of Correspondent
name
status
 
Correspondence address if different from above
address: 
postcode: 
tel
 
Is your Organisation a Registered Charity?
 Yes
 No
  Charity Registered Number:

 

 

Do you have a Constitution?

 
 Yes
 No
 

Please give brief details of the aims
of your Organisation:

 

Do you have an equal opportunities policy?

 Yes
 No

 

We agree that the above information will be held on the Dudley CVS database

signed: 

date

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