The Communication & Promotion Alliance

Application Form !

Please note this information will remain confidential to the co-ordinator of the Alliance, who will liase with the applicant on aspects of registration and issue of the Alliance card. Once the holder has received his or her card, he/she will be placed on the mailing list of the Alliance e-newsletter, issued from time to time to update holders on relevant information on the partners and their selected benefits.

Name:
Business organisation (if any):
Position held:
Contact telephone numbers:
Contact cell number:
e-mail address:
Personal interests (eg, hobbies and sports, other):
Physical address (for delivery of Alliancecard):