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Advice Dorset Network – Application Form 2016 – 2017
Thursday 21st April 2016
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Organisation Name
*
Contact Name
*
Job Title
*
Telephone
*
Email
*
Key services provided
*
Annual Membership Fee (Payment will be requested in the week beginning 4th April 2016)
*
Under £10,000 (£20 Fee)
£10,001 to £50,000 (£100 Fee)
£50,001 to £100,000 (£150 Fee)
£100,001 to £500,000 (£200 Fee)
Over £500,000 (£250 Fee)
Dorset County Council Team (£25 Fee)
Select applicable based on annual organisation income relating to work done in Bournemouth, Dorset and Poole.
Please tell us what training you would like us to provide (subjects/skills/other):
*