Membership Application Form

Membership Application Form

Charity registration number 1126930
Are you applying as a

Community group or local agencyIndividualLocal BusinessOther
Name of individual or representative for organisations*

First NameLast Name
Organisation or Business name
Email
example@example.com
Day time phone number

Area CodePhone Number
Mobile number
Address*

House name/number

Street Address

Village/Town

Postcode
Full members are expected to attend the AGM & are entitled to vote
Associate members will be consulted on development but will not have a vote at the AGM which they are welcome to attend.
NB staff and volunteers of the Advice Service mayonly apply to be an associate member.
Membership type

Full MemberAssociate Member
I would be interested to become involved with the work of the charity

Campaign and research work to improve social conditionsBecoming a trustee of the charityFundraising on behalf of the charityVolunteering in another capacity
Please tell us why are you interested in becoming a member of West Somerset Advice*
All Members agree to attend General Meetings and take an interest in the operation and development of the Company and its business. Members have a duty to respect the confidential nature of the business decisions of the Company.
Membership commitment*

I undertake to support the charity and have read the membership commitment.
Data Protection Consent*

I consent to the use of information given in this application form to consider my application and understand that it will be treated confidentially at all times and that if I am concerned about how my data is handled I can complain to the Information Commissioners Office https://ico.org.uk/for-organisations/report-a-breach/
Please indicate if you are willing to complete diversity monitoring information*

YesNo
Please either submit the form or return paper copy to

West Somerset Advice, Market House Lane, Minehead, TA24 5NW or by email

Admin@citizensadvicewestsomerset.org.uk
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