REACT Membership Form
Organisation:...........................................................................
Name:.....................................................................................
Address.............................................:.....................................
Postcode:.....................................Fax:.....................................
Telephone:...................................Email:...................................
TYPE OF MEMBERSHIP PLEASE TICK
INDIVIDUAL Waged: £10.00 [
] Unwaged: £5.00 [
]
Separate membership of the permaculture association UK is available on a separate form which is available on request from the Permaculture Association UK.
COMMUNITY GROUP £25[
]STATUTORY BODIE £30[
]CORPORATE £100[
]
We would welcome any information on any services you provide/interest in REACT
BECOME A FRIEND OF REACT. I WOULD LIKE TO DONATE £
Cheques should be made payable to REACT.All Members will be kept up to date with events and activities in and around Cardiff on a broad range of issues. If you would not like to be kept updated please tick [
]. Full Members are invited to participate in meetings and to help out/take part in events and projects.
I enclose payment of £
.
Signed
Date
BANKERS ORDER (aka Standing Order)
Name and address of bank:.............
.........................................
Account number:...........................
.. Account name:..
...............
INSTRUCTIONS TO BANK: Please pay now and monthly/quarterly/annually (delete as appropriate) on the same date, the sum of £............. to The Co-operative Bank Plc, POBox 101, 1 Balloon Street, Manchester, M60 4EP for the account of 'REACT' (a/c 6509504700, sort code 089299) using reference:
Your name (initial and family name):.
....................................
Your address: ......................................................
.................
Telephone:...............................Your Signature:......
..................
Data Protection Act 1998
This Act came into force on 1st March 2000 and gives protection to data about identifiable individuals. A large amount of the information that REACT gathers relates to other organisations, but we recognise that there are areas of our data collection & use that are covered by the Act.
Please tick [
] if you use a private address as your organisations contact address & do not wish it used in mailing lists or on the Web.
Please return your payment and completed application form to:
REACT c/o, 9 Court Rd, Whitchurch, Cardiff, CF14 1HN
Tel: 029 691781 or 0845 4582759 (local rate) Email: littleeiffel@hotmail.com |
