Personal Membership Application Form
(For sole traders, consultants and individual artists etc)
New Membership/Membership Renewal
Contact Name:
..................................................................................................
Job Title:
..................................................................................................
Contact Address: ..................................................................................................
..................................................................................................
..............................................
Organisation (if appropriate):
Type of Organisation:
...................................
Postcode
..................................................................................................
..................................................................................................
(Sole Trader, Consultant, artists. etc)
Telephone No:
............................................ Fax:
...................................
Email address:
............................................ Regional Arts area:
…....................
Membership: (please note that part-year membership is available for members joining within a membership year)
£96 (£80.00 + VAT) per Membership: Order No: .....................................
£50.40 (£42 + VAT) for students/unemployed/retired
(Please Tick)
Please Invoice Me
Name & Address for Invoice
If different from above:
..........................................................................................
..........................................................................................
Signature:
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We are considering producing a 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 artsdevUK@aol.com www.artsdevelopmentuk.org
Company registration 7983980 Charity registration 1146670