Membership Application Form
17/18 /
Wiltshire Village Halls Association
Associate Membership Form
2017-2018 / /
I would like to join Wiltshire Village Halls Association for the period 1st April 2017 – 31st March 2018.
Title / Initials / SurnamePosition Held (Main Contact)
Village Hall or Building Name
Address
Postcode
Tel (Home) / Tel (Work) / Tel (Mobile)
Email Address
Your Committee
So we can maintain accurate records, please provide the name and email address for the following Officers of the above named Village Hall or Community Building. Should a member of the committee listed below leave, please provide us with updated contact details.
Chairman
Full NameEmail Address
Secretary
Full NameEmail Address
Treasurer
Full NameEmail Address
Respecting Your Privacy
CommunityFirstislegallyboundbytheDataProtectionAct1998toensurethatpersonalinformationisonlyusedforthepurposeforwhichitwasrequestedandtoensurethatthedataisheldsecurely.Likeothercharities,weuseyourinformationinconnectionwithouractivitiesandfundraisingappeals. Yoursupportisvaluabletousandfromtimetotime,wemaywishtocontactyouaboutourwork,activitiesandevents as well as to send you members updates and information.
I would prefer not to receive any communication from WVHA/Community First (Opt-out)I am happy to receive updates from WVHA/Community First (Opt-In)
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Membership Type (Tick)
£Wiltshire Village Halls Association / 40.00
Please indicate your preferred method of payment for the membership type selected above and any other voluntary donation you may wish to make.
Cheque / Please make cheques payable to ‘Community First’Standing Order / If already paying by Standing Order remember to update the amount with your bank
BACS / CAF Bank Ltd: Account No 00084711SortCode:405240QuoteReference:Hall Name
Membership of Wiltshire Village Halls Association also entitles your committee to free membership of Community First. Please see the attached information leaflet for details of these extra membership benefits.
Signature / DateCompleted Forms
Please return this form along with your membership contribution to:
Wiltshire Village Halls Association
C/O Community First
Unit C2, Beacon Business Centre
Hopton Park, Devizes
SN10 2EY
Alternatively, you can email your completed form to:
Helen Cotter:
Jennie Lane:
OFFICE USE ONLY
Date / Initial
Membership Application Received
Membership Fee received
Confirmed Membership Date
CF MEMBERSHIP FORM 17/18 / Page 1