Next-of-Kin or Representative's Consent Form

This form must be completed by the nominated representative before we can accept instructions from a new member.
* indicates required information

The person below or, if deceased his/her legal representative, has asked me to be his/her nominated representative to act in his/her place after his/her death with the right to attend and vote at Annual General Meetings.

Title: *
Forename(s): *
Surname: *

Next-of-Kin or nominated Representative.

Relationship to Member: *
Title: *
Forename(s): *
Surname: *
Address line 1: *
Address line 2:
Town/City: *
County: *
Postcode: *
Phone: *
Mobile Phone:
Email: *

By sending this form you confirm that you accept our Membership Rules which you can read here and consent to us holding your personal data. Any personal data we hold will only be used to contact you about your role as a represntative, to send you information about the Association or to comply with our statutory duties. We will not pass your data to any third parties and you have the right to ask for a copy of the data we hold at any time. We prefer to send you future communications by email. I am happy to receive communications by email OR please send by post

I have read and accept the Membership Rules and consent to my personal data being held:

(please click this box)