AVSM Membership

Terms:

£45 / Year

First Name:* First Name Required

Last Name:* Last Name Required

Contact Number:* Contact Number is Required

Job Title:* Job Title is Required

How long have you been in post?:* How long have you been in post? is Required

Name of Hospice/Organisation :* Name of Hospice/Organisation is Required

Postal Address:* Postal Address is Required

Web Address:* Web Address is Required

AVSM Region:* AVSM Region is Required

Number of volunteers:* Number of volunteers is Required

Number of staff (including you) in your Volunteer Services team?:* Number of staff (including you) in your Volunteer Services team? is Required

Total number of staff?:* Total number of staff? is Required

Is your Hospice a Child or Adult Hospice or both?:* Is your Hospice a Child or Adult Hospice or both? is Required

Is your Hospice a member of Hospice UK?:* Is your Hospice a member of Hospice UK? is Required

Is your Hospice a member of Together for Short Lives?:* Is your Hospice a member of Together for Short Lives? is Required

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Password Strength Password REQUIRED must be 20 Alphanumeric Characters, and "Very Strong" or "Unbreakable".

Credit Card

Name on the card:* Name on the card is required.

Credit Card:*

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I have read and agree to the Terms & Conditions.*

Data Protection - The Association maintains a database of members’ details, as on this application form. These details are used only for the purposes of mailing to members. You may receive some communication via e-mail. You can view our Privacy Policy.

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