Registration Form

Annual Membership Subscription Rates
Number of Employees
 ICT Company (Total number of employees in organisation)
User Company (employees within IT department only)		 Subscription Rates
1-5 £85 + VAT
6-10 £275 + VAT
11-20 £500 + VAT
21-50 £675 + VAT
51+ £850 + VAT
Affiliate Companies - (organisations offering services to Momentum members, such as legal, financial and recruitment companies) £750 + VAT
Short Company Name : :
  
Company Name (Full) : :
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Contact Firstname : :
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Contact Surname : :
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E-mail Address : :
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Web Address : :
  
Address : :
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Town / City : :
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Post Code : :
  
No. of employees : :
   *
Telephone : :
   *
Fax : :
  
SORCE Link : :
  
Business Profile : :
   *
    Tick here to agree to the Code of Conduct
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