Corporate Membership Form

Please complete the form below if you are interested in joining as a Corporate Member, once we have received your form we will be in touch to arrange payment.

If you have any questions or require further information please contact Harriet Hickin at hhickin@lrwt.org.uk or call 07719 956090

View the membership options

Organisation name

Address Line 1

Address Line 2

Address Line 3

Postcode

Website

Briefly describe your business

Representative Contact Full Name

Representative Contact Email

Representative Contact Tel

Choose your membership type

Wildlife Supporter

(£500 yearly)

Wildlife Guardian

(£1000 yearly)

Wildlife Partnership

(£2500 yearly)

Please indicate your payment method

BACS

Direct Debit

I would like to receive further communications from Leicestershire & Rutland Wildlife Trust by:

Email

Post

Your details will be used for Leicestershire and Rutland Wildlife Trust purposes only. We will process, protect and store your data in accordance with our Privacy Policy, available here.

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Corporate Membership Form