Membership Registration Form – Iteso welfare Association UK

Name *

First

Last

Telephone

Mobile Phone *

Email *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Preferred Communication Method *

Age categories :Tick relevant category *

Any other ethnic classification please provide specific details.

What is your ethnic group? *

What is your gender? *

What is your sexual orientation? *

6. Would you like to volunteer your skills ? List skills set….

Please Tick to indicate if you read the following with the application *

Copy of The Constitution
Business Plan
Code of Conduct
I would like to become a card holding member of Iteso Welfare Association (IWA)
I accept that my membership application will be vetted by the Board of Trustees of IWA , If I am accepted as a member my details will be held on secure database and will not pass on my details or of any other member(s) on to any third party.
I accept to pay my Membership fees and Annual subscription on time
I understand that I have a right to see personal details held by Iteso Welfare Association (IWA) upon request.
I understand that I have to pay my membership and annual Subscription fees on time.

Signature *