Membership Type

This form will take approximately five minutes to complete.

Select membership type

Company Name

Employer contact name

Contact number

If you are unsure whether you are able to benefit from this discounted Corporate rate please contact us by clicking here.

Which States Department / Office?

Point of contact

Contact number

{{ dependant.Name }} {{ dependant.Gender }} {{ dependant.Dob }} {{ dependantPrice(dependant) }} X
Add dependant
{{ AddDependantError }}

£{{ totalUpfront }}to pay up front

Joining Fee {{formatCurrency(joiningFee)}}{{formatCurrency(undiscountedJoiningFee)}}
Membership Cost £{{ fee }}£{{ undiscountedFee }}
Primary member £{{ feePrimary }}
For the remainder of this month {{formatCurrency(proRata)}}{{formatCurrency(undiscountedProRata)}}Your Direct Debit will not be setup in time for your first payment so you will need to pay your first month up front.
Total to pay up front {{formatCurrency(totalUpfront)}}
You save {{formatCurrency(totalSavingsToday)}} if you subscribe today!
Monthly cost starting {{ ddStart }} £{{ fee }}£{{ undiscountedFee }}
Primary member £{{ feePrimary }}£{{ undiscountedFee }}