DCA Membership - Associate Membership - Group

The Associate Membership – Group is available to Businessses, Charities, Agencies and other groups who:

This type of membership is intended to build relationships between the community and the groups.

It is not a pure commercial advertising opportunity.

If you meet these criteria then please fill out the form below.

For the membership application only one contact is required.

If other people in the group wish to be on the mailing list then please send an email to dca-membership@dirletonvillage.org

Group Formal Name
Group short Name (abbreviation or known-as name) (if applicable)
Company Number/Charity Number/Agency Reference (if applicable)
Please select group type
Address Line 1
Address Line 2
Village/Town/City
Postcode
Details of Nominated contact
Salutation
First Name	Last Name
Email Address
Phone Number
I confirm on behalf of the above group that we meet the criteria for membership as above Tick Box to confirm