Professional Lighting and Sound Association - Centre of Expertise

Please complete all sections of the form.

Remember to provide your payment details - we cannot process your application without this.

Student Membership of PLASA is free.

There are 4 different categories of membership you can apply for

Business Premier Standard

Individual

Educational Provider Student

Affiliate Company Individual

If you belong to a Group and another company in the Group is a member, please select up to three names from the drop down lists below:

Business details

Name of Company or Individual applying:

Company No:

Address:

Postcode:

Country:

Tel:

Fax:

E-mail:

Web:

Number of employees:

Date of formation:

Your personal details (for internal use only)

Name:

Job Title:

Tel:

Direct E-mail:

Please supply the details of your referee(s)

(If possible, please choose PLASA Members - current list of members. If you do not have a business relationship with a PLASA Member, we will accept references from established contacts or clients. Students only need to supply the details of their Course Tutor.)

We recommend that you contact your nominated referees in advance and ask them to support your application.

Reference 1 (Please supply FULL contact details)

Contact Name:

Organisation:

Please indicate your relationship with this organisation:

Course Title: (if student)

Course Start Date:

Course End Date:

Address:

Postcode:

Country:

Tel:

E-mail:

Reference 2 (Please supply FULL contact details)

Contact Name:

Organisation:

Please indicate your relationship with this organisation:

Address:

Postcode:

Country:

Tel:

E-mail:

Method of payment

Pay by Direct Debit and Save Money

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Cheque

Please make your cheque payable to PLASA and send it to:

PLASA Membership
Redoubt House
1 Edward Road
Eastbourne
BN23 8AS
United Kingdom

Credit/Debit Card

Name on Card:

Credit Card No:

Expiry Date:

CCV:
(The last three digits on the signature strip on the back of the card, or the four digits above the credit card number on the front of American Express cards.)

Issue No:
(Switch only)

I apply for membership of PLASA and agree to be bound by the constitution of the Association.

I also agree to operate to the agreed standards and ethics laid out in the PLASA Code of Professional Practice.

Name:

Date:

Professional Lighting and Sound Association - Centre of Expertise

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