Membership Application Form

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Membership Application Form

Required fields are marked with *

Is your application for a renewal? *

Yes
No

Your PUK membership number: *

Has PUK increased your contact with others in the sector? *

Do you feel that your services have improved due to being a PUK member? *

Are you better informed of developments in the parenting field? *

Full Name (including title): *

Job title (in full): *

Organisation (if relevant):

Address: *

Postcode: *

Work telephone: *

Home telephone:

Fax:

In order for Parenting UK to provide you with a valuable service it is essential that you provide us with an up-to-date email address as this will allow you access to online services and regular email newsletters.

Email: *

Website:

Other contacts

Do you require an invoice?

Please tick the government region(s) in which you work:*

Channel Islands
East Midlands
East of England
International
London
North East
Northern Ireland
North West

Scotland
South East
South West
UK-wide
Wales
West Midlands
Yorkshire & the Humber

In which sector do you mainly work?

Please tick one of these terms as representative of the type of organisation you work in: *

Academic / Research
Community
Consultancy
Education (preschool to secondary)
Faith
Family / Children's Centre
Freelance practitioner
Funder
Further / Adult education
Government department
Health (including PCTs, hospitals, GP practices, health centres)
Information service
Justice
Local authority
Media
Multi-agency team
Private
Professional Association
Social services
Training
Voluntary

Please tick up to six of these terms to indicate the client group / area that you work with / in and rank them in order of importance from 1 (most important) to 6: *

Accreditation
Adoption / fostering / children looked after
Adult relationship guidance
Antenatal / Postnatal
Bereavement
Bullying
Campaigning
Child protection
Childcare
Ethnic minority communities
Evaluation
Family learning
Fathers
Gay and lesbian parents / children
Grandparents
Health promotion
Home / school partnerships
Information
Lone parents / blended families
Mental health
Mentoring / coaching
Parenthood education in schools
Parents of adolescents
Parents of babies
Parents of children 1-4
Parents of children 5-10
Parents of children with special needs / learning difficulties
Parents with special needs / learning difficulties
Poverty / deprivation
Prisoners
Refugees / asylum seekers
Research
Rural issues
Social policy
Special needs / learning difficulties
Substance misuse
Young offenders
Young parents
Work / life balance

Please indicate all government initiatives which your work falls into (such as Sure Start, Extended Schools, Children's Fund, YOT etc.):

Please tick this box if you/your organisation work directly with parents:

If you deliver parenting programmes please specify which ones here:

Please describe your work:

How did you hear about Parenting UK? *

Data Protection Regulation

Parenting UK exists to foster the exchange of information, and the data you supply will be used for this purpose. In order to spread good practice we may pass your details to other members and genuine enquirers. If you DO NOT wish your information to be shared in this way, please tick here:

Parenting UK will also seek to send out VIA EMAIL an electronic version of our regular News Bulletin and information on current developments in the sector via weekly email updates. If you DO NOT wish to receive these via your email address then please tick in the boxes below:

PUK bulletin via email
Updates via email

Declaration

I agree to subscribe to the principles of Parenting UK: *

Membership Rates

The membership year runs from April to March.

New members pay for the months remaining in the year in which they join (joining month included) and will receive a renewal notice for the following April. Members joining between October and March (inclusive) can choose to pay for the rest of the current membership year together with the full subscription for the following year.

Corporate members are able to register a number of staff who are all eligible for discounted services.

Please tick the membership required: *

Individual (£3 per month)	3.00
Organisations with a turnover of less than £50k/3 staff (£4 per month)	4.00
Organisations with a turnover of £50k to £500k/7 staff (£10 per month) 2 hard copies of bulletin	10.00
Organisations with a turnover of £500k to £1m/12 staff (£17 per month) 3 hard copies of bulletin	17.00
Organisations with a turnover of more than £1m/18 staff (£25 per month) 4 hard copies of bulletin	25.00
Please tick here if you wish to pay for this year and the next together

Do you wish to pay for another complete year?

Please tick here if you require an invoice
Total Price	£

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8th March 2010

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