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Membership form

Please fill in the parts of the form marked required

Membership category

Membership of the Forum is open to:

Individual Black and Minority Ethnic people who live or work within the boundaries of the city of Bristol.
A minority or ethnic person is someone who could experience discrimination on the grounds of his or her colour,race,ethnic or national origin.
Or an organisation or group of Black and Minority Ethnic people who are based or work within the boundaries of the city of Bristol.

Please indicate which category you will be joining (required).

Individual
Organisation

Individual Application

Name
Address


E-mail
Phone number
Alternate address / telephone

	Please restrict my details to Equalities Team only
	Only Forum members can have access to my details
	These details can be circulated to all interested parties

Group Application

(Women’s Group, Women’s Work Group)

Group name
Contact name
Address


E-mail
Phone number
Website

Please check box if you do not want our website to link to yours

Note that your details will be entered into the Equalities Team database.

Your group is invited to nominate up to two representatives and two substitutes.

Representative 1

Name
Address


Phone

Representative 2

Name
Address


Phone

Substitute 1

Name
Address


Phone

Substitute 2

Name
Address


Phone

Your language needs

I would like information in
Other requirements

How did you learn about the Forum?

word of mouth
advertisement
internet
Bristol City Council Leaflet
LED screen in Broadmead

Other (please specify)

Send message

If you have any queries please do not hesitate to contact The Bristol City Council Equalities Unit on:
Telephone 0117 922 2660
Fax 0117 922 2392
Textphone 0117 922 2661