Membership Application form By submitting this membership application form you are affirming that you/your organisation meets the NACCOM Membership criteria. In advance of completing an application please read our membership criteria. See here for the Project Directory where information about approved member organisations is shared. You can use the below form to update what details you would like to be shared. Name of person completing application form* First Last Role titleIf relevant, please provide the name of your organisation's CEO or equivalent First Last Primary email address* Please note email is our main form of communication so if this changes at any time let us know.Email address for our Project Directory (if different) If you have an email address that you would prefer we use publicly please provide this, otherwise leave blank.Registered address Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Occasionally we may need to send out postal correspondence. Please provide the registered address that you would like any correspondence to go to. Your phone number*This is the main phone number we will use for correspondence. Phone number for contact on our Project Directory (if different)If you have a phone number that you would prefer we use publicly please provide this, otherwise leave blank.Website (if you have one) Twitter account (if you have one) Facebook page or group (if you have one) What type of membership are you applying for?*Full Member Organisation (our organisation provides or is setting up to provide accommodation for destitute refused asylum seekers)Associate Member Organisation (our organisation is in support of the aims of NACCOM)Associate Individual Member (I am in support of the aims of NACCOM)For our membership criteria and details of fees, visit www.naccom.org.uk/get-involved/membershipName of organisationIf your organisation is a registered charity please provide your charity numberIncome (either last financial year or expected for this year if newly set up)Type of accommodation you provide:HostingHousingNight ShelterHosting, housing and night shelterHosting and housingHosting and night shelterHousing and night shelterReligious communityOtherNumber of people accommodated by your service this yearFurther details about your work:Use this space to tell us more about why you want to join the network.How did you find out about NACCOM?Which of the below details about you/your organisation can we share e.g. on our online Project Directory (for organisations only) or Members Area (all members)* Select All Name Address Email address (first one listed) Email address (second one listed) Phone number (first one listed) Phone number (second one listed) Website Social media Further information about your work Logo (please attach) Please tick as many as are relevant to your application. If you do not wish us to share any information about your project on the website please leave this section blank. To see the Project Directory visit https://naccom.org.uk/projects/Logo and other pictures you wish to share Drop files here or Accepted file types: jpg, gif, png, pdf. SUBSCRIBE ME TO RECEIVE UPDATES FROM NACCOM- We are committed to data privacy and will only send you information that is relevant. Thank you for your interest in joining the network. Please click submit and we'll be in touch. This iframe contains the logic required to handle Ajax powered Gravity Forms.