Arts Development UK Organisational membership application form

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Organisational Membership Application Form
New Membership/Membership Renewal
Local Authority/Organisation: ..................................................................................................
Type of Authority/Organisation: ................................................................................................
Contact Name: ..................................................................................................
Job Title:
..................................................................................................
Contact Address:
..................................................................................................
..................................................................................................
..............................................
Department:
Postcode
...................................
..................................................................................................
Telephone No: ............................................
Fax:
...................................
Email address: ............................................
Regional Arts Office
...................
Membership: (please note that part-year membership is available for members joining within a
membership year)
£175.00 + VAT per organisation:
Order No:
..................................... Please Invoice Me
or I enclose a cheque
(Please Tick)
Name & Address for Invoice
If different from above: ..........................................................................................
..........................................................................................
Signature:
..................................................................................................
We have an online member’s directory and occasionally share information with other arts and cultural
organisations.
Please tick the box if you do not wish your information to be shared.
Arts Development UK Administrator, Oak Villa, Lower Brynamman, Ammanford, Wales SA18 1SN
Tel/Fax 01269 824728 email [email protected] www.artsdevelopmentuk.org
Company registration 7983980 Charity registration 1146670
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