Application For Membership

Membership runs from 1st Jan for 12 months. If you apply during the last three months of the year, these months are included in your first year's membership, ie. you get up to 3 months free!

 First name  Last name

Please fill in at least one of the following areas, preferably both.

Home Address   

Home Telephone        Home Fax  

Home e-mail      

Use home address

Work Address   

Work Telephone         Work Fax

Work e-mail       

Use work address

I hereby give permission for my contact details to be included in the NAME membership list for the purposes of the Assocation and its members only.
yes
no

I give my consent for my details to be included in the list of members in the members-only section of the NAME Website.
yes
no
 
Mobile   
 
I will post a cheque (see below for rates)
I will post a Direct Debit instruction form to NAME* (see below)
Direct Debit already set up
 
£20 individual 1st year Special Offer rate applies
£50 individual 1st year Special Offer rate applies
£70 individual 1st year Special Offer rate applies
 £27 standard individual rate applies
£63 standard individual rate applies
£90 standard individual rate applies

 
Trading companies (eg publishers, retailers, software developers) can apply for corporate membership. Please contact musiceducation@name.org.uk for full details.

If you are an NQT please see the 'Free NQT Membership Offer' on the web site front page.

* For Downloadable/Printable Direct Debit instruction form in PDF format click here.
 
Please Insert Anti-spammer Security Code Here: Security Code is

OPTIONAL SECTION
 
To help us provide the best possible service it would assist us greatly if you could also complete the following.

Place of Work       Job Title 

Please give a brief description of your work experience and your present job:-

Please tick the specialist interest focus group(s) most relevant to your work:
Curriculum Secondary
Primary
Instrumental
Advisers
Inspectors
Consultants
ITE/HE

Please state where you heard of NAME:-

Please select your age group:
under 30
30-39
40-49
50-59
60 and over

Do you consider yourself to have a disability/impairment?
yes
no

Please indicate gender:
male
female

Please indicate your ethnicity:
These categories of ethnic origin are recommended by the UK Commission for Racial Equality as the most appropriate for monitoring in the UK. We recognise however that the specified categories may not be appropriate for everyone. If this is the case please use the text box.
 
Asian or Asian British:
Indian
Pakistani
Bangladeshi
Other Asian (please complete box below)

 
Black or Black British:
Black Caribbean
Black African
Other Black background (please complete box below)

 
Chinese or Other:
Chinese
Other (please complete box below)

 
White:
English
Irish
Other white background (please complete box below)

 
Mixed:
White and Black Caribbean
White and Black African
White and Asian
Other white background (please complete box below)

 
Latino:
Latino
 
Thank You!

Please check all details before Submitting and wait for acknowledgement before pressing any other key or button.

Cheques should be made payable to ‘NAME’ and sent to:-
Helen Fraser, NAME Administrator, Gordon Lodge, Snitterton Road, Matlock, Derbyshire, DE4 3LZ 

  For Downloadable/Printable version of this application form in PDF format click here.