testform – Southend Mencap

Please complete and return this form if you would like your organisation to benefit from the many advantages of being a member of RRAVS.

Membership Application Form

Full legal name of your organisation:*
Full legal name of your organisation:*
Abbreviation or Acronym that your organisation is generally known by:
New Application?*
Yes
No
Renewal?*
Yes
No
Is your organisation part of a regional or national network?*
Select one or both options
Contact Information
Address*
Street Address Address Line 2

Phone
Mobile
Email

Website

What is the main purpose of your organisation?

Email
This field is for validation purposes and should be left unchanged.

Regional
National