Application Form

Name of Organisation/group:


Contact name:

Phone number (please do not leave any spaces):


Email address:


Nature of business:



Please provide details of the products you wish to sell:


Please provide 50 words that we can use on our Assembly website to promote your involvement:


Please provide your website url (if you have one): 


Please click on the 'Send' button below to submit your request to our Assembly Administrator.
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