Membership Registration Form

1. Title *
2. First Name *
3. Surname *
4. Home Phone Number *
5. Mobile Phone Number *
6. Email Address *
7. Re-enter Email Address *

1. Business Name *
2. Address 1 *
3. Address 2 *
4. Address 3 *
5. Address 4 *
6. Postcode *
7. Business Phone Number *
8. Business Fax Number
9. Business Website
   e.g. http://www.google.co.uk
11. Business Category * Please SelectChauffeur ServicesCoachworks and Body SpecialistGarage ServicesTaxi ServiceValetingVehicle Hire / LeasingArchitectBuilderCarpenterCarpet FitterChartered SurveyorCurtains and BlindsDecoratorElectrical ServicesInterior DesignerLandscape GardeningLocksmithPlumberProject ManagerBusiness ConsultantBusiness DevelopmentBusiness MentorCommercial CleaningCorporate/Executive CoachCourier ServiceEvent OrganisationHR ConsultantImport and ExportManagement Development and TrainingOrganisation and Change ManagementProperty InvestmentQuality (ISO) ConsultantRecruitment ConsultantSecurity and CCTVStatic GuardingTelemarketingTraining ConsultantAccountant and TaxationAsset FinanceBankingBook - keepingChartered AccountantConsultantDebt CollectionDebt ReliefIndependent Financial, AdviserInsolvency PractitionerInsurance ConsultantLeasingMortgages, Insurance, Business LoansStockbrokerAcupunctureHealth ProductsHolistic HealthHomoeopathHypnotherapyMassagePersonal Fitness CoachStress Management ConsultantElectrical Safety TestingFirst Aid TrainingHealth and Safety ConsultantHealth and Safety TrainingConference and BanquetingHealth ClubHotelRestaurantComputer Hardware SupplyComputer SupportData RecoveryOverseas Property SpecialistsSoftware DevelopmentSpeech RecognitionCarpet and Upholstery CleaningDry Cleaning and Ironing serviceFloristLife Style and Concierge servicePrivate DetectiveUndertakerWedding co-ordinatorBusiness SolicitorCopyright and Trade MarkMediation serviceServiceSolicitorWill Writing ServiceAdvertisingCorporate ClothingDesignerDirect MailE-MarketingProfessional WriterPromotional goodsPublic RelationsStrategy and PlanningBusiness NewspaperCommercial PhotographerGraphic DesignerLocal MagazineLocal website directory and magazinePA systemsPrinterPublic RelationsSign MakerVideo ProductionWeb design and DevelopmentWedding and Portrait PhotographerWriter - Business and/or copyCartridge and Toner refillingOffice FurniturePhone Answering servicePhotocopier supplierStationeryVending machine supplierVirtual OfficeArtistEducation trainingImage ConsultantLife CoachNetwork MarketingNetwork Marketing ProductsPersonal Care ProductsAdvanced Driving TuitionCharity OrganisationsExecutive Travel and Concierge ServiceMembership OrganisationsTravel agentGas, Electricity and other servicesMobile PhonesTelecommunications (fixed line)Discount Utilities ClubEnergy saving Company

1. Preferred Club * Please SelectAxe ValleyBarnstaple ChichesterBathBicesterBirminghamBlanford ForumBoltonBournemouthBridgwaterBridportBrightonBristolBristol RedwoodCamborne RedruthCardiffCheltenhamChepstowChichesterChippenhamCirencesterCreweDorchesterDursleyEastbourneExeterExmouthFalmouthFarehamFraddonFromeGloucesterGreat YarmouthGrimsbyHarrogateHastingsHelstonHonitonHuddersfieldKeynshamLeedsLincolnLiskeardLondon BridgeLutonManchesterMembers left folderMid DevonMilton KeynesMineheadNeath South WalesNewportNorth TamarNorthampton RacecourseNorthampton WoottonNorwichOxfordPenzancePlymouth CentralPoolePort TalbotPortisheadPortsmouthPrestonReadingSalisburySaltashScarboroughScunthorpeShaftsburySloughSouth DevonSouthamptonSt AustellStokeStroud and Five ValleysSwanseaSwindonTauntonTavistockThornburyTruro ThreemilestoneVictoria RocheWarringtonWellingtonWellsWeston Super MareWeymouthWinchesterWorcesterYeovilYork
2. Sponsored By
   Membership number of sponsor

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