Membership Form

Please first read the Membership information here before applying using the form below.

Application

To apply for membership please complete the form below.
Alternatively you can click here to download a paper copy of the form to complete and return by post.

 

Organisation Name

Contact Name

Role in Group

Address

Email

Phone

Mobile


Type of organisation : (please tick)
Registered CharityConstituted CharityAffiliated to a Larger OrganisationOther (please specify in the details box below)

Details :


Are you applying for : (please tick)
Full MembershipAssociate Membership

Aims of Organisation

Activities

Catchment Area

No. Of Paid Staff

No. Of Volunteers

Please tick to confirm you have a formal written safeguarding policy
Yes


I agree/disagree to Swindon Youth Partnership storing this information to be used by them for data collection and contact purposes only :
AgreeDisagree


I agree/disagree to this information being shared with other parties concerned with the development of services for Children and Young People in Swindon :


I confirm that my organisation supports the aims and objectives of Swindon Youth Partnership and that I am the voting representative for my group

Voting Representative:

Name :

Position :

Date :

Please tick the box to provide an electronic signature :
Signed

Management Committee Chair:

Name :

Please tick the box to confirm that you have the permission of your management committee to apply :
Signed