Membership Registration Form

Title: *

Forename: *

Last Name: *

NLCCE Username:

Position: *

Business Name: *

Business Address: *

Business Postcode: *

Business Legal Status: *

Date Business Registered: *

No. of Employees: *

Mobile Number: *

Business Number:

Email: *

Website:

Please add http:// or https:// when entering your website Business Type: *

Please create a username and a password. Once your account has been verified, you will need these to log in to your account in order to create your online directory entry. Passwords must be at least 8 characters long and contain at least 1 number, 1 uppercase letter and 1 lowercase letter. Your email and username will be reserved within your session for 30 minutes to allow for payment, if payment is not made within this time, you will need to submit this form again.

Username: *

Password: *

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Confirm Password: *

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Please tick if you would like to opt in to our mailing list – to receive invites to networking events and be informed of other business opportunities and initiatives:

Privacy

The details you have provided on this form will be added to the NLCCE database. We respect the privacy of all our service users, for full details please see our Privacy Policy, which states how we collect, store and secure data – it can be viewed on our website: Privacy Policy

Please tick to confirm that the details you have provided are correct and you agree to your information being stored according to our Privacy Policy.

NLCCE Membership Terms and Conditions

Please tick to confirm you have read and agree to abide by the NLCCE Membership Terms and Conditions

By clicking Register you will be taken to an online payment gateway to make your relevant membership fee payment – according to the information you have provided in this form (whether you are a start up, charity or how many employees you have). Please see membership rates below:

Membership fees per annum
Charity	£110.00
Start up (registered under 18 months)	£110.00
Businesses trading over 18 months:
1-5 Employees	£165.00
6-10 Employees	£220.00
11-49 Employees	£385.00
50-99 Employees	£715.00
100-249 Employees	£1045.00
250+ Employees	£1650.00

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