Individual Membership Application Form

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THIS FORM IS SOLELY FOR INDIVIDUAL MEMBERSHIP AND THIS CATEGORY IS ONLY OPEN TO INDIVIDUAL PEST CONTROL TECHNICIANS EMPLOYED WITHIN THE INDUSTRY (IN RECEIPT OF A WAGE/SALARY) AND OTHER INTERESTED PERSONS. Please note that Individual Members may not use the Association logo for any purpose whatsoever.

Your Contact Details

Name*
Address
Email (direct)*
Are you a member of a CPD scheme?*
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    Do you agree to your membership details being held on an electronic database?*
    Do you agree to your details being passed on to a third party for promotional purposes?*

    Employer Details

    Declaration

    I declare that the information given on this application is correct.*
    I understand that my application will be rejected/membership terminated if I give any information that I know to be false or I withhold any other relevant information.*

    To the board of directors of the NPTA Limited ('The Association')

    By completing the below section and submitting your application, you are signing to confirm that you are applying to be admitted as a full member of the NPTA Limited and agree to be bound by the provisions of its memorandum and articles of association.
    Do you agree to comply with the NPTA code of practice?*
    Please refer to our Resource Hub on the NPTA website to read our Code of Practice
    Do you agree to comply with the NPTA Articles of Association and memorandum*?*
    *Available on request.
    Name*
    Clear Signature
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