SENDPO Membership Form for Disabled Freelance Consultants

Section A: Contact Details

Your Name

Your Business / Company Name (if applicable)

Postal Address
Line 1
Line 2
Line 3
Town / City
County
Postcode

Telephone Number

E-mail Address

Website Address

Section B: Your Business

What is the legal status of your business?
Sole Trader		Company Limited by Shares
Company Limited by GuaranteeRegistered Charity		Community Interest Company (CIC)

Please give a short description of the services you offer using no more than 100 words.your work using no more than 100 words.

Please tell us which counties you are willing to work in.
Berkshire		Hampshire		West Sussex
Brighton and Hove		Kent		South-East
Buckinghamshire		Oxfordshire		National
East Sussex		Surrey

Once you click the "Submit" button your form will be sent to SENDPO's Policy and Development Officer.  If you have any questions please contact Theresa Hodge by telephone on 0333 5779874 / 07967 622405 or by e-mail at theresa@sendpo.org.