Membership Application Form Membership Application Form Title * Ms Miss Mrs Mr Other If other, please state Forename * Other Initials Surname * Company Name * Job Title * Company Address * Are you a Charity * Yes No If you answered yes, please pur your Charity Number below Number of Employees * Email Address * Telephone Number * Second Contact: Name Second Contact: Job Title Second Contact: Email Address Please select the groups that you wish to join. The Chair of the Group will then make contact with to inform you of the quarterly meeting dates. (You can select multiple groups) Low Carbon & Contruction Creative & Digital Manufacturing & Engineering Finance & Business Services Transport & Logistics Education & Skills Health Retail & Hospitality Culture & Tourism Sport & Leisure Housing Your Authorisation * Monthly Direct Debit One-off Annual Fee (Save 10%) Data Protection (The Wakefield Bondholder Scheme will process your membership information for administration purposes. We may also send you newsletters and let you know about other members’ services) * Please tick If you do not want any information relating to other members’ services. Please tick If you do not want us to share your information. APPLY TO BECOME A MEMBER If you are human, leave this field blank. FOLLOW US