Group Membership Form - The Voluntary Network

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The Voluntary Network
GROUP MEMBERSHIP APPLICATION FORM
Please Complete in BLOCK capitals.
Name of Organisation:
Contact Name:
Address:
Post Code:
Telephone Number:
Names of persons authorised to book vehicles on behalf of your organisation:
Name and Address to which invoices should be sent:
In case of an emergency:
Name:
Tel:
Organisational Status
Is your group:
Profit-Making?
A Community/ Voluntary group?
A Statutory Body?
A Registered Charity?
YES/NO
YES/NO
YES/NO
YES/NO
Our minibuses may only be used by groups involved in one or more of the activities
listed below:
Tick those with which your group is concerned
Education □
Religion □
Recreation □
Social Welfare □
Please specify any other activities that are of a benefit to the community of which your organisation takes
part in:
Aims of Organisation:
People with whom your organisation is concerned:
People with a physical disability
□
People with dementia
□
People with a learning disability
□
Elderly People
□
People with a mental health problem
□
Pre-School groups
□
People from ethnic minorities
□
Women’s group
□
People with an alcohol related problem □
Youth groups
□
□
Health groups
□
People affected by drug problems
Other please give details
Declaration
Our organisaton agrees to abide by the terms and conditions as set out in The Community Transport
Partnership Minibus Hire Policy, and we understand that any breach of these conditions may result in
our group being expelled from membership.
We understand that vehicles are for hire subject to availability.
We understand that The Community Transport Partnership is registered under Data Protection Act
and we consent to The Community Transport Partnership holding the above information about our
organisation.
Signed:
Print Name:
Position:
Date:
Please make all cheques payable to The Voluntary Network
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