North West Fraud Forum - Membership Form

Company Name

Address

Town/City

County

Post Code

Business Activity

Number of Employees (select "0" for self employed)

Job Title

If you are purchasing Corporate Membership (five members for the price of four) it is essential to nominate the first applicant at this time, but the names of remaining applicants can be provided at a later date.

First Applicant (Name)

Email address (required)

Telephone/Mobile

Second Applicant (Name)

Email address (required)

Third Applicant (Name)

Email address (required)

Fourth Applicant (Name)

Email address (required)

Fifth Applicant (Name)

Email address (required)

Please select the type of membership required:

Single Member £60.00 plus VAT (Total £70.50)
Corporate Membership £240 plus VAT (Total £282.00)

Membership fee is valid for one calendar year, or part thereof, from the 1st April to 31st March. Once your application for membership has been approved an invoice will be sent via email with payment options.