Application form

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Subscription type

Subscription rates: £7.50 p.a. for Individual or Household.

Individual
Household

For other types of membership (e.g. Corporate/Organisation) please contact the Membership Secretary or Treasurer.

Principal contact details

First Name

Last Name

Street address

Town

Post Code

Address line 2

e.g. Village

Phone

This is the main phone number to contact you in the event of (for example) event cancellation.

Alternative phone

Mobile phone number for above-named person if the main phone number is a land line.

Additional member

One additional member may be added here (other than for individual subscriptions). Other members can be added once the application has been processed.

First Name (additional)

Last Name (additional)

Email (additional)

Phone (additional)

Usually the personal mobile phone of the additional member.

At least the "First Name" box must be filled in order to create an additional member record.

Source

Please let us know how you learnt about us:

Payment information - individual sub

Amount due = £7.50

Payment information - household sub

Amount due = £7.50

Payment Method

Sorry - no cheques

Bank transfer

Bank Transfer is currently the only payment method accepted. We hope to introduce Direct Debit in the near future, which is a time-saver for all concerned.

Please read the waiver:

Waiver (opens in new tab/window)

I agree to the waiver in relation to my participation in the group and its events

Are you human?

What is 2 + 3?

Membership Type

Contact: secretary@cumbriaorganic.org.uk