Application Form for membership

Cost of membership is £10 for individuals and £30 for organisations.

Arts & Health South West is working hard to make this a FREE Membership but we won't be able to confirm this until the 31st March 2010.

However we are pleased to announce that anyone who joins up until that date will enjoy the discounted 'end of the year' rate.

This means membership is currently only £10 for an individual or £30 for an organisation.

The application form will take about 5-10 minutes to fill in as it asks you lots of questions about your work - this means we can build up a really detailed picture of the Arts and Health sector in the South West which will help us achieve our aims of promoting and supporting the sector. The information will also be used to help people search on our on-line directory (at the end of the form you choose which personal details you want made available).

Your Contact Details:

First Name:
*

Surname:
*

Job Title:

Organisation:

Address line 1:
*

Address line 2:

Town:
*

County:
*

Postcode:
*

Telephone:
*

Mobile:

Email:
*

Website:

Description:
*


Do you wish to join as an individual (£10) or an organisation (£30) ?
individual     organisation