Group Membership Application

About the Organiser
Name*
Title First Last
Organisation Address*
Street Address Address Line 2 City County PostCode Country
Phone*
Emergency Contact
Name*
First Last
Phone*
Position within the organisation.*

Payment Information
1) Cancellation fees apply on booked trips. (£25 more than a week, £35 less than 3 working days and £50 less than 24 hours.)
2) Should an individual wish to use our transport schemes then an individual membership must be applied for and fee paid.
Name of Organisation Transport Is provided for*
Name of Organisation to be invoiced*
Person / Job Title responsible for payments*
Address to which Invoices should be sent*
Street Address Address Line 2 City County Postcode Country

Contact us today to find out more

Community Link Stafford & District

Support your community

Car drivers are needed to help with transporting our clients to and from hospitals including other medical appointments and shopping trips.