This registration form is only for use by applicants who have been approved by the membership and this approval has been confirmed to them in email by either the CRX chair or membership secretary.  If you are interested in joining CRX, please contact to find out more about applying. We have a one member per business area rule, so the Group will need to approve your application before you can submit this form and the fee. If you make payment without having obtained approval from CRX, we will return your payment after deducting a £20 administration fee.

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Please include as much detail as you can, as this information will be used for the online directory on our website and our printed booklet, which is published twice a year. If you don’t have a organisation logo or a headshot image available now, don’t worry, you can add it later.

• You and your business

• First Name*
• Last Name*
• Job Title
• Organisation
• Category* CRX only allows one member per business category. This field describes your category eg "fire & security", "care at home", "HR Consultancy", "Cost Management", "General IT Support", "Accountancy". Please be as specific as possible.

• Contact Info

• E-mail*
• Work Phone Required phone number format: (+44) ##########
  
• Mobile Required phone number format: (+44) 7### ### ###
  
• Website
• Address line 1
• Address line 2
• Town / City
• Post Code
• Facebook Enter the url of your Facebook page eg https://www.facebook.com/mycompany
• Twitter Enter the url of your twitter account eg https://www.twitter.com/mycompany
• LinkedIn Enter the url of your LinkedIn account eg https://www.linkedin.com/mycompany
• Instagram Enter the url of your Instagram account eg https://www.instagram.com/mycompany

• Company Description

• Company description*Brief description (no more than 600 characters, including spaces and punctuation) for use in the full list of members on the website and the printed directory of members.
• Head shotUpload A good quality head shot in .jpg or .png format, with minimum dimensions of approximately 1200 pixels width x 1600 pixels height and a file size of at least 200Kb. For use in the full list of members on the website and the printed directory of members. If you don't have an image available now, you can add it later.
• Organisation LogoUpload A good quality logo image for the member's organisation in .jpg, .png or .gif format (minimum 1024 pixels width x 996 pixels height). For use in the full list of members on the website and the printed directory of members. If you don't have an image available now, you can add it later.

• Create your CRX website account

• Username*
• Password* Minimum length of 8 characters.
• Repeat Password*

• Agreement

• I agree to the CRX Charter*You must agree to our terms and conditions in order to become a member of CRX ( View Charter)
• I allow the website to collect and store the data I submit through this form. I agree that CRX may share information about me and my organisation through the CRX website, emails, social media and printed mailshots.*

• Marketing fund contribution

  Membership of CRX is only by approval from the members. It is a condition of membership that all members pay an annual, non-refundable, contribution to the CRX Marketing Fund. You must ensure that your application for membership has been approved before making this payment. Members are expected to attend meetings as often as possible (at least 50% of meetings). As a member, your details will be included in the online and printed members directory.
  CRX Members - £80 / 1 Year

  Following approval by the membership, complete this form and make the required contribution to CRX's marketing funds in order to benefit from full membership of CRX. This includes attendance at weekly meetings and inclusion in the directory of members, which is displayed on our website and published to print twice a year.
  Automatically renew subscription

Select a Payment Method

Manual/OfflineCredit / Debit Card

No payment methods are available for the selected subscription plan.

• Credit / Debit Card Information

• Billing Details

• Billing First Name*
• Billing Last Name*
• Billing Email*
• Billing Company

  If entered, this will appear on the invoice, replacing the First and Last Name.

• Billing Address*
• Billing City*
• Billing Zip / Postal Code
• Billing Country*
  AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the CongoReunionRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe
• Billing State / Province