PART 1:

Please complete this secure online form accurately otherwise we cannot approve your membership.

Alternative pdf form to complete and post.

Official Online Application Form:

Club or Full Member (Please specify)
First Name:
Surname:
Date of Birth _ _/_ _/_ _ _ _:
Organisation (If applicable):
Telephone (Mobile/Land line):
E-mail:
Address 1 (Number & Street):
Address 2 (Town):
Address 3 (County):
Address 4 (Country):
Address 5 (Post Code):

If you have already decided on your 'beneficiary organisation' please enter their details here:
You can complete it at a later time - there is no rush.

I accept that sending my details confirms acceptance of THE MEMBERSHIP CONTRACT AND MY MEMBERSHIP WILL COMMENCE ONLY AFTER I HAVE RECEIVED MY MEMBERSHIP NUMBER.

After you have sent your details you will taken to a payment page - thank you.

"CLUB MEMBERSHIP SPECIAL OFFER":

If, AS A PROSPECTIVE CLUB MEMBER, you cannot afford to pay at the time of joining - then don't - instead we will deduct the first £75.00 of your ONLINE financial benefits to cover your contribution - if you don't gain financially then we don't get any donation from you - simple and without any conditions - this offer is only for 'Club Members' AND ENDS ON THE 12TH DECEMBER 2012.

Please tick the box if you wish to take advantage of this SPECIAL OFFER - You will not have to pay in Part 2 - but please SEND YOUR DETAILS BELOW.