CSC :: Apply

Organisation Name:

Title:
Firstname:
Surname:

Address:
City:
Postcode:

Telephone:
Fax:
Email Address: The email address must be that of a named person ie not "enquiries" or "info" nor similar

Please select the option that most accurately describes your organisation's activities:	Claims Management Company Law firm (solicitor or chambers) Claims handler/manager (non legal) Medico-legal agency Rehabilitation/treatment provider Insurer Endowment/Financial Services Other

Membership Type	firms with ten employees or more - £960 plus VAT per annum firms with fewer than ten employees - £480 plus VAT per annum

Please state which regulatory body you are registered with:

If you are Ministry of Justice registered, please give your registration number:

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Membership Application