Group Membership Application/Renewal Form 2018-19

Before applying for membership, please ensure you are familiar with the Group Membership Pack and agree with the Terms & Conditions.


Group name:

Address (including post code:)

Address for correspondence (if different:)

Group email address:

Principal booking person:

Telephone:

Day: Evening:

Invoices to be sent to (if different):

Telephone:

Day: Evening:

Address (to which all invoices will be sent:)

Unless otherwise notified we shall assume that this person is also authorised to make bookings

Other authorised booking personnel


1

Name: Tel. no: Position:

2

Name: Tel. no: Position:

3

Name: Tel. no: Position:

4

Name: Tel. no: Position:

Tick to confirm:

My group is a non-profit making organisation and wishes to join/renew membership of Wandsworth Community Transport.

We agree to abide by WCT's current Terms and Conditions of use. I agree to be personally responsible for all bookings made in the group's name by authorised people and for the payment of all invoices.

Are you renewing an existing membership?

    No

If so, there is no need to answer the questions below concerning membership verification, but do please update your monitoring information.

Equal Opportunities Monitoring and Membership Verification

As Wandsworth Community Transport is fully committed to the promotion of equality both in the provision of its service and as an employer, we would be grateful if you could give us some details of your membership. We may need to ensure that your intended use of our service complies with our Terms and Conditions before we accept your membership application.

Aims and objectives of your organisation:

Please email or send us a copy of your constitution, information leaflets or similar documentation describing your organisation and demonstrating your standing in the community, proof of address and eligibility for membership. Send this by post if you have joined on the internet.

Intended use of our vehicles:

Details of someone who can act as a referee for your organisation:

This should be someone in a position of authority, a Council official, Leader of a fellow organisation or existing WCT member who can vouch for your organisation and credit worthiness.

Name:

Address:

Tel. no:

Membership of your group

Please estimate the total number of different people using our services during the course of the year:

Male:

Female:

How many of these would describe themselves as having a disability:

Please give an estimate of the number of your members who would describe their ethnic origin as listed below:

White:

Black/Caribbean:

Black/African:

Black/Other:

Indian:

Pakistani:

Bangladeshi:

Chinese:

Other Asian:

Mixed:

Other:

How did you come to hear of the services provided by WCT?