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home > networks > lacl > application form

To join the LACL membership scheme either

Fill in the online form below to register your interest and receive a pro forma invoice from CIRIA, or

Download application form, and fax or post completed form with payment to CIRIA

 

Application form for LACL membership

Network members are entitled to send a maximum of two people from their organisation to each event free of charge.

Please complete details

Fields marked with an asterisk * are required.

Salutation*

Initials*

Surname*

Email*

Telephone

Fax

Job Title

Company

Company Type

Address*

Town*

County

Postcode/ Zip*

Country

 

I wish to join the Local Authority Contaminated Land Network;
Annual subscription fee: £555 +VAT

Order Number*
All applications must be accompanied by an order number

Local Authority cluster group special offer

Existing cluster group rate for 5 - 9 members £455 + VAT please phone me to discuss this membership
Existing cluster group rate for 10 plus members £350 + VAT please phone me to discuss this membership

 

How did you hear about CIRIA's LACL membership scheme?

Other please specify

 

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