Membership Form

Membership Registration

To use our services we ask for an annual membership fee of £5.

The information in this document is considered to be strictly confidential and will only be used by Arun Community Transport. It will be kept secure and never passed to anyone outside the organisation unless the law permits. Arun Community Transport will keep your information until you inform us that you no longer wish this. By completing this consent form you give permission to Arun Community Transport (ACT) to hold your personal details to assist them in providing relevant services. Details may also be used to provide updates on any ACT news and operational matters.

Name

Address

Phone

Date of Birth

Emergency Contact Name and Phone Number

How did you hear about us?

Thanks for registering. We will be in touch. Now make a payment please.

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