Group Application

Membership Application or Renewal

Name

Address

Phone Number

Details are for administrative purposes only and will not be shared with any third party. All data will be stored in accordance with the Data Protection Act 1998 and 2018. To advise us of any other changes relating to your group, please contact hacmembership@outlook.com.

Fees and payment details

Please tick appropriate box for payment amount and method, At least one box MUST be ticked for each

Please tick appropriate box for payment amount and method.

Individual membership £5

Payment Details

Cheque (payable to Havering Arts Council)

Direct transfer to Lloyds: Havering Arts Council Account number 25732968 Sort code 305466

Please tick this box if you agree to us contacting you in the future regarding Havering Arts Council matters. We will not sell or pass on your data to third parties (note we will be unable to contact you or keep your details updated on our website without this permission).