PLEASE PRINT THIS PAGE AND RETURN IT TO
ADDRESS ON PAGE 2
monmouthshire GreenWeb
Membership Application Form
Name
of Organisation Applying
..
Type
of Organisation
.
(e.g.
voluntary group, statutory body, consultancy)
Details
of Contact Person: Name
..
Postal
Address
...
...
(with
postcode)
Telephone
E-mail
Address
.
Fax
.
.
Details
of Representative to Attend Formal
Meetings (if different from above): Name
Postal
Address
...
(with
postcode)
Telephone
E-mail
Address
.
Fax
.
.
Details of any Alternate or Substitute Representative: Name
..
Postal
Address
...
(with
postcode)
Telephone
E-mail
Address
.
Fax
.
.
Please could you tell us the
aims of your organisation and how it
works to promote sustainable environmental
initiatives? (Please attach any relevant
materials)
.
...
...
What
geographical area do you cover?
.
.
.
Does
your organisation have a web site? If yes, please give address
.
...
Does
your organisation have a local newsletter distributed to your members and/or
the public?
Please give brief details
including
frequency
.
..
.
..
Would
your organisation like to have a page on the GreenWeb web site? YES NO
On behalf of the organisation named above I apply
for membership of Monmouthshire GreenWeb and confirm that, if accepted, the
organisation and its representatives will comply with the GreenWeb Terms and
Conditions of Membership (available on the web site or from the Secretary).
Signed
.. Print name
.
Position
.. Date
...
.
Please return to Sue Parkinson (GreenWeb Coordina\or), Mulberry Cottage, Welsh Newton Common, Monmouth,
NP25 5RT
Telephone: 0845 4580254 (local rate). E-mail: sue@sueparkinson.biz