Group Membership Application

Membership is open to any group which operates “not for profit” . Our prime purpose is to provide a service for those people unable to use other forms of transport.

Your group must operate within, or for residents of, Wokingham District Council or Bracknell Forest Borough Council, but we can travel anywhere outside these areas. Please note that membership does not automatically guarantee transport.

There is a one off registration fee, plus an annual subscription which enables you to use our Contract service subject to availability. The current fees, along with further information, can be found in the Group Membership Pack which also contains contains our Terms and Conditions of membership. Once your application has been approved we will ask for payment of all fees, which can be made by credit/debit card over the phone or in our office. Alternatively you can pay by cheque or BACS. There is no refund available once the registration has been made.

Click Next to apply for membership on line. If you prefer to send us a paper application the membership pack also contains a Membership Application form.

About your group

Please complete all fields marked with *

First name*

Name of group*

Address (for correspondance)*

Post code*

Contact name*

Telephone*

Is your meeting place (if any) different to the address above? Yes No

Meeting place address*

Do you want to be contacted by email? Yes No

Email address*

Is you group for people with a disability? Yes No

Details of disability*

Purpose of Group*

Any other details (300 chars left)

How did you hear about Keep Mobile?

Declaration

I am applying for Group membership.

I/we have read a copy of and agree to abide by the terms and conditions of the charity and any updates to these that may be issued. I/we understand that no transport can be guaranteed and that bookings must be made as early as possible to minimise refusals. Payment for transport is due within 14 days of the date of invoice. Payment can be accepted by cash or cheque raised in the name of the organisation or one of its members. This group is not connected with or associated with any organisation operating with a view to profit.

I/we acknowledge that I/we will be required to pay the registration and subscription fees as detailed in the Group Membership Pack once this application is approved.

I confirm that I have read and agree with the Privacy Policy for Members of Keep Mobile.

I am the named contact from the previous page

Your name*

Your position within the group*

I confirm that the information I have provided in this form is correct to the best of my knowledge.

Please check this box to confirm your application*

I wish to pay by credit/debit card

Thank you!

Your membership application has been submitted successfully. We will do our best to get back to you within one working day. If you have entered an email address we will respond by email. Otherwise we will get back to by phone.

The Keep Mobile Team