(Please complete this box ONLY if you are renewing your membership)
NAME OF ORGANISATION / GROUP *
CONTACT FORENAME *
CONTACT SURNAME *
ADDRESS 1 *
ADDRESS 2
ADDRESS 3
CITY *
COUNTY *
POSTCODE *
TELEPHONE *
EMAIL *
Journeys are invoiced at the end of every month after the journey has been completed. Where would you like the invoice to be sent?
Please answer every question
Is your group profit-making?
Yes No
Is your group a community/voluntary group?
Is your group a statutory body?
Is your group a registered charity? (please state number below)
(Tick those with which your group is concerned)
Education
Religion
Recreation
Social Welfare
Other activities of benefit to the community? (please state below)
Give brief details
(Tick as many boxes as are relevant)
People with a physical disability
People with a learning disability
People with a mental health problem
People from ethnic minorities
People with an alcohol related problem
People affected by drug problems
People affected by HIV or AIDS
People with dementia
Elderly people
Pre-school groups
Youth groups
Women's groups
Other (please state below)
Our organisation agrees to abide by the terms and conditions as set out in the Huntingdonshire Association for Community Transport conditions of hire, and we understand that any breach of these conditions may result in our group being expelled from membership. We understand that Huntingdonshire Association for Community Transport does comply with the Data Protection Act and we consent to Huntingdonshire Association for Community Transport holding the above information about our organisation.
YOUR FORENAME *
YOUR SURNAME *
YOUR POSITION *
