Membership Application
&
Donation Form
NETWORK 81 offers free advice to all parents and organisations. We also offer membership for
individuals and groups who would like to keep in contact with the support services we offer. If you
do not wish to become a member, but wish to support our work, please consider sending a donation.
All funds from membership go towards continuing our national programme of parental support and
training.
I/We share the aims of NETWORK 81 and would like to receive regular newsletters and any other
information on activities.
Please indicate membership type by placing a tick in the relevant box.
£20 Annual Individual/Family Membership
£25 Annual Group Membership
£35 Annual LEA Membership
I apply to become a member of Network 81, a company limited by guarantee, and, in the event of the
company being wound up while I am a member, or within one year thereafter, to contribute the sum
of £1.00 if required.
*Please make cheques payable to “Network 81”
Name:
(Mr/Mrs/Miss/Ms) …………………………………………………………………………….
Address:
…………………………………………………………………………………………………...
…………………………………………………………………………………………………..
Post Code:…………………………………. Tel No: …………………………………………………….
LEA: …………………………………………………………………………………………………………..
Dated:
………………………
DONATIONS
Signed: ……………………………………………………………..
Please find enclosed my donation of £………………………………..
GIFT AID DECLARATION FOR TAXPAYERS
If you are a UK taxpayer please tick the box below to enable Network 81 to claim 28p from the
taxman for every £1 Donation/Subscription.
I declare that donations/subscriptions I make on or after this date are Gift Aid Donations
N.B. You must pay an amount of income tax or capital gains tax equal to the tax we reclaim on your
donations (28p for every £1 that you give). Please let us know if your circumstances or address
details change so that we can amend our records.
Please return to : Network 81, 10 Boleyn Way, West Clacton, Essex, C015 2NJ
Tel: 0845 077 4055
Company Limited by Guarantee. Registered in England No. 3334432, Registered Charity No. 1061950
FURTHER INFORMATION:
Do you have any particular experiences; concerns that you need help with or would like to share
with Network 81? Do you need any help with any particular problem? (Enclose a separate sheet if
necessary)
For professionals please state role and interest.
The information you provide helps Network 81 assess services it needs to provide
and keep users of the service informed of new developments and maintain
awareness. Information is not passed to a third party and is held securely.
Helpline 0845 077 4055
www.network81.org
email: Network81@hotmail.co.uk