Membership Application

Phone: 01243 869662 // Email: [email protected]
Name
Email
Password
Address
I am happy to apply to become am member CAPITAL(Required)
This is not an application for employment. By signing this application, you agree to abide by the CAPITAL Agreement and its Policies and Procedures which can be seen on our Membership or upon request to our enquiries email.
This information will NOT be shared with any third parties.
Emergency Contact Address
This will help us to support you and your needs appropriately, specifically if you need access to transport, venues and your general welfare.
For example: • Any interests or hobbies e.g. arts and crafts • Your journey through the mental health system • Would you be interested in joining in with Peer Led Training (e.g. Self Esteem and Boundaries)
Data Capture – Consent
Please pick one
Disability
Please Tick Those That Apply
Mental Health Condition/s
Please Tick Those That Apply
This field is for validation purposes and should be left unchanged.

‘The atmosphere was very friendly, I could be open and honest without being judged.’

CAPITAL member

Newsletter Signup

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Contact information

Membership & Engagement Coordinator

Tabitha Thomson (Pronouns: She/Her)

Email: [email protected]

Phone: 01243 869662

General Enquiries

Email: [email protected]

Phone: 01243 869662