A
Company Limited by Guarantee no 3875010, registered charity number 1079126
Registered
Office: Bank House 20 St Edward Street
Tel/Fax: 01538 381356 e-mail: leek@smcvs.co.uk
C.V.S. MEMBERSHIP 2008/2009
We
. (Name
of organisation)
Hereby wish to become
members of Staffordshire Moorlands C.V.S. for 2008/2009 and enclose our
membership fee of £10.00.
We hereby agree to guarantee
the sum of £10 in the event of the winding-up of the Company. (This is a nominal figure which does not
require payment, but
is a members guarantee required as a Company Limited by Guarantee).
SIGNED
. DATE
..
CHAIRMANName: Address: Tel No: |
SECRETARY
|
TREASURER
|
Contact for all correspondence: NAME ................
ADDRESS
..
Post code
TELEPHONE
NUMBER
.
e-mail
address
.. website
..
DATA PROTECTION INFORMATION STATEMENT
We will use the information you have provided (and any other information you may provide us with in the future) for purposes relating to services
provided by the Staffordshire Moorlands Community and Voluntary Services. We will not disclose this information to any other person or organisation
without your authority as below:
In connection
with our services from time to time we may disclose this information to other
voluntary, statutory, community groups for mutual benefit.
If you object to such disclosure please tick here.
Directories of
voluntary organisations are produced containing brief details of each organisation
together with contact name and address.
These may well be web-based If you do not wish your
organisation to be included in the directory please tick here.
Please sign here to show you agree to us using your data in the way
indicated.
Signed ___________________________________ Dated
__________________________
N.B. Please send a copy of your organisation's constitution and your completed form, together with a cheque for £10.00 made payable to
"Staffordshire Moorlands Community and Voluntary
Services
to: Mrs J Dale, SMCVS, Bank House,