About your charity organisation

 

Charity organisation name

 

 

 

 

What services does your charity provide

 

 

 

Number of volunteers

 

 

 

Number of staff

 

 

 

Location charity covers

 

 

Contact details

 

Named contact for all communication

 

 

 

Contact postal address

 

 

 

Contact telephone number

 

 

 

Contact email address

 

 

 

Charity organisation  website

 

 

Data Protection (please tick)

 

Can we share your contact email and website address on our website?

 

 

 

Can we use your details to contact you about news and events from MAD Scotland?

 

 

Membership

 

Registration for a charity group is free and you’ll receive a certificate of registration. If you’d like to purchase a window sticker (£5.00 each) or patches (£3.50 each), please include details of how many and enclose the correct amount in a cheque made out to MAD Scotland with your registration application.

 

 

 

Signed

 

 

Date