Membership application form
Join Basingstoke and District Disability Forum (BDDF) to find out about events and services, local initiatives, meetings, partnership opportunities and other disability-related information. Please see overleaf for definition of types of membership available.
ü To join BDDF as an individual, please complete parts 1 & 3
ü To join BDDF on behalf of an organization or company, please complete parts 2 & 3
Part 1 (personal membership)
Your name: ………………………….…………………………………………..…...………….
Home address: ……………………………….……………………………………….………..
………………………………………………………………… Postcode:………………….…
Email address: ………………………………………………………………….…………..…
Phone number(s): ………………………………………………………………………….…
Part 2 (organizational/corporate membership)
Name of organization/company: …………………….……….…….………………….…....
Postal address: ………………………………………….…………….…………….…………
……………………………………………..…………………. Postcode: …………………...
Contact in organization/company (name and role/job title): ……………………………..………………….………………………….……………….……..
Email address: ………………………………..……… Phone number: ……………………
Part 3 (personal and organizational/corporate membership)
Areas of disability that are of interest to you (please list below)
……………………………………………..……………………………………..…………….
………………………………………………………………...…......
……………………………………………………………………………………………….…..
……………………………………………………………………………………………….…..
At BDDF we take your privacy seriously. We will only use your personal information to contact you and let you know about our services and activities.
From time to time we would like to contact you with details of other organisations who we feel may be able to provide you with helpful information. If you consent to us contacting you for this purpose, please indicate below how you would like us to do so:
Post☐ Email☐
Please delete / cross out the sentence below which is NOT applicable:
I agree to BDDF keeping my details
I do not agree to BDDF keeping my details
Signature: ……………………………………………..……… Date: ……………….…
Please return this form to BDDF for your application to be processed
By post to: Facilitator, BDDF, The Orchard, White Hart Lane, Basingstoke, RG21 4AF
or via email to:
Types of BDDF membership
· Individual (personal) - receive our newsletters and invitations to our events.
· Organizational – in addition to individual member benefits, be listed on our website and have opportunities to partner with us at BDDF events and activities.
· Corporate – in addition to individual member benefits, be listed on our website, have opportunities to partner with us at BDDF events and activities, and enjoy priority contact for staff volunteering opportunities.
Like many other charities, BDDF relies heavily on financial support to maintain the high standards demanded of it. However, we also recognise the importance of continuing to build relationships with individuals, other charities, companies and the local community in general. For this reason, BDDF has decided to waive all membershipfees for the time being. Voluntary donations, however small or large would, as ever, be welcomed and applied responsibly.
www.bddf.org.uk
OFFICE USE ONLY
Date received: Database updated: q