New individual membership application

This is an application form for an individual such as a student, artist or parent to join Southampton Scrapstore as a new member.

Individual membership provides you with one membership card for a single named individual to use. This will grant you access to the scrapstore for one visit each week, with recycled resources being charged at £1.50 per  small bag, £2.50 per large bag and £5 per huge bag. If you are already a member or your membership has expired within the last month, you may renew your existing membership instead of completing the form below. If you wish to apply for a different kind of membership, please select the appropriate form from our membership page.

If the person who is paying your membership has a different name to the name on your card  please email us to let us know.

Individual membership costs £19.50 for the first year. After completing this form you will be directed to the PayPal website where you can pay securely online.


About you

Your Name (required)

Your Email (required)

Your Address

Postcode:

Telephone (landline)

Telephone (mobile)

Roughly how many people will benefit from your membership of Southampton Scrapstore?
Adults:
Children:

Final bits

How did you hear about us?

We'd like to keep you up to date with what's going on at the Scrapstore by sending you our newsletter and other occasional updates. We promise not to share your details with anyone else. Would you like to join our mailing list?

By submitting this form, you are making the following statements:

  • I am aged 18 or over
  • I have read the terms and conditions of membership
  • I agree to abide by the terms and conditions of membership
  • I agree to the contents of this form being transmitted over the Internet and stored by Southampton Scrapstore for administrative purposes
  • All the information on this form is correct to the best of my knowledge
  • I agree to pay the current membership fee for the type of membership selected above.

Please confirm:

After submitting this form, you will be directed to the PayPal website where you can securely pay for your membership using your PayPal account.