Membership Form

Forest Pulse

C/O Heart of the Forest Community Special School,
Speech House, Coleford, Glos, GL16 7EJ

Tel/Fax: 01594 826357`

 

MEMBERSHIP FORM Please complete the details below in order to be registered as a member of Forest Pulse. Membership runs for the full or part year up to the next Annual General Meeting. Membership will be renewed automatically at each AGM unless you notify the office in writing that you wish to cancel your membership. Membership is applicable until the child is 19 years old. If you are not involved in any Forest Pulse activities for a period of two years, and have no other contact with the group for that period of time, membership will be suspended. However, membership can be renewed at any time by contacting the office. Membership covers your whole family and each registered family is entitled to one vote at the AGM. All member families are encouraged to send at least one representative to the AGM, as it is the responsibility of all members to discuss and vote on matters affecting Forest Pulse.

 

NAME OF PARENTS:........................................................................................................

ADDRESS: .........................................................................................................................Post Code ...................................................................

TELEPHONE NO: ................................................................. Mobile ..............................................................

EMAIL ADDRESS: ..............................................................................

 

Names of all Children
Dates of Birth
What Special Needs does Child have?
School attended
Does Child have a Statement of Education needs?

 

 

 

 

       

 

 

 

 

 

 

 

 

I agree to the above information being included on the Forest Pulse Mailing List Database

 

Signature of behalf of family: ............................................................................................

Date of signing: ...............................................................................................................

 

NB. Please remember to notify the office of any changes in the above details.

For office use only:

Source of referral ..............................................................................................................