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* 1. Organisation Name

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* 2. Organisation Post Code

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* 3. Applicant Contact Name

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* 4. Applicant Email Address

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* 5. Applicant Contact Telephone

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* 6. Please detail how the COVID-19 pandemic is affecting your business operationally and financially, in order to support your relief request?

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* 7. Please confirm how much percentage of your membership fee you would like to apply for?

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