Membership Form

"Out at Tesco" Membership Form

The Lesbian, Gay, Bisexual and Transgender Network (only name, email and Tesco Employee Number fields are mandatory)

Q.1

Name *

Title

First Name

Last Name

Q.2

E-mail address *

Please ensure your e-mail address is correct as this is our only way to contact you.

(e.g. john@example.com)

Q.3

Tesco Employee Number *

(e.g. 01234567)

Q.4

Date of birth

DD
/

MM
/

YYYY

Q.5

Membership - I am interested in joining as:

an Active member – I will be actively involved in the network, participate in events and/or be part of the mentorship programme.
a Basic member – I will receive news from the network on a regular basis, and be invited to the network social events.

Q.6

Mentoring - I am interested in being:

Our confidential mentoring programme is built to help you increase your confidence and be yourself in your work environment.

Q.7

Networking events - please indicate your preferred city (e.g. London, Manchester, Edinburgh, Cardiff etc):

Q.8

Sexual Orientation

Q.9

Gender

Q.10

Please tell us more about you (e.g. where you work) and your expectations for being a member of the network