Membership Payment Form

	Price per Annum	Please tick option required.	

Pump Centre Membership
Level 1	
£4500 (Ex VAT)		

Pump Centre Membership
Level 2	
£1700 (Ex VAT)		

Pump Centre Membership
Level 3	
£1700 (Ex VAT)		
Combined Membership 
Level 2 & 3	£2960 (Ex VAT)		

Payment Details	Please tick option required	
A Cheque made payable to “Arcadis Consulting (UK) Ltd” will be posted to the address below.	
	
Please find an Order Number below against which you can invoice for the 

Order Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ 	

Contact Name	
Address	
Telephone Number
	
Email address	

Please complete and:

E: mail to karen.bridgeman@arcadis.com   or

Post to: The Pump Centre, Arcadis, 5th floor, 401 Faraday Street, Birchwood Park, Warrington, WA3 6GA