David Pye

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					                            Wirral Environmental Network
                                           environmental education charity
                                    “Working to reduce Wirral’s Carbon Footprint”
                           Wirral Environment Centre, Falkland Road, WALLASEY CH44 8ER
                           Tel: 0151 639 2121 Web site www.la21.net E-mail: info@la21.net
Patrons: Tina Fox, Professor John Guillebaud, Jonathon Porritt, Charles Secrett, Dr Joanna Sharples, Pat Sykes, Mary Woolley
                                                                            09/06/2010
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                                                          APPLICATION FOR SCHOOLS MEMBERSHIP

                     The current annual subscription rates are: Primary Schools £30; Secondary Schools £50

Name of school........................................................................................................................
Primary or Secondary?.........................................

Name and address of contact:
First name.....................................................Surname............................................................................................................
Address...................................................................................................................................................................................
.....................................................................................................................................Post code...........................................
Tel......………...........Mobile..............…… Fax.........……..….............e-mail............................................................................
Web:……………………………………………………..Position in school.............................................
Approximate no. of pupils…………
Please give details of any environmental activities that your school is engaged in. These will be included in your entry in
our list of groups, organisations, schools and businesses that goes to all members. Continue overleaf if necessary.
...................................................................................................................................................................................................
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Likely level of support:
1. Active support ......... 2. Specific support on request........ 3. Sorry, too busy - support via subscription only.........

I apply for Schools membership of Wirral Environmental Network on behalf of the above School. I enclose a cheque
for................(payable to Wirral Environmental Network). I understand that this will be refunded if my/our application for
renewal is unsuccessful.

I state that I/we agree with and will support the objectives of Wirral Environmental Network, as stated in the Charter, and
I/we accept, and agree to be bound by, the Articles and Memorandum of Association and the Bye-laws of Wirral
Environmental Network.

Signature.............................................................................................Date..................................................................

                             Please return this form to: Les Bufton, 34 Ford Road, Upton, WIRRAL CH49 0TF




    Wirral Environmental Network is a registered charity (1068306) and company limited by guarantee (3462312). It is a non-profit, non-party political coalition of
                               individuals, groups, organisations, schools and businesses working together for a sustainable future.
                                      Registered office: Wirral Environment Centre, Falkland Road, WALLASEY CH44 8ER
    For Office use: Chq:          Approved:                                Acknowledged:                                             WEN Schools application

				
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