MEMBERSHIP APPLICATION FORM

Contact Name:

Job Title:

Organisation:

Registered Address:

Postcode:

Email:

Tel:

Fax:

Website:

Please tell us briefly how your work relates with active learning for active citizenship and include your website.

Membership rates, please tick the category you want:

Public sector organizations (local authorities, universities etc) £120 per year

VC sector (charities, non for profits etc) £60 per year

Individuals £12 per year

Membership rates, please tick the category you want

By cheque, made payable to Take Part Network

By BACS

I know Take Part Approach and I subscribe to its values and principles.