Membership Application and Renewal Form 1Primary Membership Contact2Organisation Status3Membership Type4Terms and Conditions Primary membership contactName First Last Job Title Organisation* Address* Street Address Address Line 2 City ZIP / Postal Code Email Enter Email Confirm Email Additional ContactsPlease give details of any other colleagues who would like to receive membership mailings. Click the + button to add rowsNameJob TitleEmail Add Remove Organisation statusStatutory / Public Sector Consumer / Regulatory Local Authority NHS / Health Registered Social Landlord Other Voluntary Sector / Not-for-Profit / Social Enterprise Charity Registered in England & Wales Charity Registered in Scotland Industrial and Provident Society Other not-for-profit/CIC/social enterprise Private Sector Energy Supplier Retail Manufacturer Installer Consultant Please select the nation / region you would like to be registered ALL WALES NORTHERN IRELAND SCOTLAND ENGLAND North East North West Yorkshire & Humber Eastern East Midlands West Midlands South West London South East Membership TypeSupporting Membership is FREE and is open to charities, Community Interest Companies, local authorities, Citizens Advice and not-for-profit registered housing providers. Supporting Membership does not include discounts on training courses or conference delegate places. Enhanced Membership (Community) is open to the above categories and includes all benefits. Enhanced Membership (SME) is open to private sector small to medium businesses with a turnover of less than £500k and includes all benefits.Which membership type are you applying for? Supporting Membership Enhanced Membership (Community) Enhanced Membership (SME) PaymentHow do you wish to pay? (Community) Invoice Credit / Debit Card Enhanced Membership (Community) CC* England/Wales/Scotland: £75 + VAT Northern Ireland: £50 + VAT Enhanced Membership (Community) INV England/Wales/Scotland: £75 + VAT Northern Ireland: £50 + VAT VAT @ 20%* Price: £ 0.00 Total How do you wish to pay? (SME) Invoice Credit / Debit Card Enhanced Membership (SME) CC England/Wales/Scotland: £300 + VAT Northern Ireland: £180 + VAT Enhanced Membership (SME) INVSmall to medium enterprise with a turnover of less than £500k England/Wales/Scotland: £300 + VAT Northern Ireland: £180 + VAT Purchase order numberPlease provide a purchase order number so that we are able to invoice you. VAT @ 20%* Price: £ 0.00 Total Terms and ConditionsBy applying for membership you agree that: You are applying on behalf of your organisation/authority and not in a personal capacity and you have the authorisation to do so. You agree that NEA can refer to your company/authority as an NEA member, and may use the company/authority logo on the members pages of the NEA website. Your organisation/authority supports the objectives of NEA. Members should behave in a way which maintains the professional standards associated with the membership of NEA as a national charity. Membership of NEA does not provide an endorsement of technical or other standards and should not imply that it does. Members may only use or reproduce NEA's logo with the written permission from the organisation. Reference to membership may be included on letterheads used for individual correspondence. Agreement* I agree to the terms and conditions outlined above GDPR*I understand that my details will be added to NEA's membership database and used to contact me with membership-related information, including newsletters. I understand that my information will not be passed to any third party unless permission is given. I agree