Company Name
Trading Name (if different)
Address 1*
Address 2
Address 3
Town/City*
Postcode*
County* / Region* / Country*

*Please ensure that all starred fields are completed, including the county, region and country fields as these are an essential part of the online search function. Without these details you will not appear in the search results.

Legal status of organisation

Limited Company / PCT/GP Commissioning Group
Public Limited Company / Strategic Health Board/ Health Commissioning Board
Local Authority/ Government Department / Academic Institution
Registered Social Landlord / Registered Charity / Number:
Partnership / Incorporated and registered outside the UK in (country)
Sole Trader / Other (please specify below)

Primary Contact

This personwill appear in the Membership Directory, on the TSA website and to whom TSA would send publications and mailings. Please complete address fields if different from above.

Name*
Job Title*
Address 1
Address 2
Address 3
Town/City
Postcode
County / Region / Country
Telephone* / Fax
Email*
Website address*

Additional Contact

Name
Job Title
Telephone / Fax
Email

Accounts Contact

Name
Job Title
Telephone / Fax
Email

Product/Service Range (where applicable)

Social Alarms / Telemedicine Equipment
Telecare Sensors / Environmental Controls
Telehealth/Vital Signs Monitors / Lone Worker Systems
Control Centre Software / Warden/Nurse Call Systems
Nuisance Call Blocking Technology / Other (please specify below)

Business Activity

Equipment Manufacture/Supply / Consultancy Services/Social Research
Software Design / Maintenance
Installation / Other Support Activity (please specify below)

Sales Turnover (per annum)

< £500,000 / £1M - £10M
£500,000 - £1M / > £10M

Geographical Reach

UK Only / North America
Europe / South America
Asia / Australia

Payment

Please provide details of how you would like to pay for your membership. If you would prefer to pay with a credit card, please select invoice below and follow the instructions for Sage Pay “Pay Now” when you receive the invoice.

By Invoice / Your BACS Reference
By BACS / VAT Registration Number
Purchase Order Number
Account Name: Telecare Services Association / Sort Code: 01-09-69 / Account Number: 61688770

About TSA

TSA exists to promote awareness of the telecare and telehealth industry, to set and raise standards for the products, services and practice within the industry, to identify and promote good practice and to support networking between members

TSA is the trading name of the Telecare Services Association, a company limited by guarantee (£1). An application for membership of TSA is an application for membership of the company. Members of TSA have rights and responsibilities. Supply Sector Members have the voting rights of Full Members. They are bound by the rules of the company and must pay any annual membership contribution set by the Board or such additional call on members as may be agreed by the membership at a General Meeting of the company. Resignation from TSA will only be accepted by the receipt of a written request to terminate membership delivered to the company's registered address. Membership Subscriptions will be sought pro rata for membership benefits received prior to receipt of the termination of membership. (A copy of the TSA Articles of Association is obtainable on request from the Company Secretary).

Please attach any product/service literature and background information about your company.

Email

TSA has the policy to use email as the primary channel to communicate information to members, including formal company notices.

Declaration

I am authorised to apply on behalf of the above named organisation for Supply Sector membership of TSA. The above named organisation supports the aims and objects of TSA and agrees to be bound by the rules of the company and will pay any fees required from members.

Name
Position
Signature / Date
I have read and accept TSA’s Conditions of Business (please tick box)

Data Protection Act 1998

Information provided to TSA will be held in an information system and processed by TSA for the purposes of membership and financial administration, customer care, delivery of membership services and TSA's own marketing and research purposes. Processing may involve the production or display of personal contact information in paper or digital form on public or private information processing or display systems, including TSA’s web site. From time to time, TSA may provide mailing services (labels or data file) to selected third parties to introduce their products or services. Should you not wish your name and address details to be supplied to third parties for this purpose, please tick the adjacent box.

Please inform TSA of any changes to the contact details overleaf in order to ensure that TSA membership database entries are accurate.

Please now return your completed form to:
TSA, Suite 8 Wilmslow House, Grove Way, Wilmslow, Cheshire SK9 5AG
Tel: 01625 520320 Fax: 01625 533021 Email:

TSA – Terms and Conditions of Business

In these conditions, the Seller shall mean the Company ‘Telecare Services Association’ and the Customershall mean the person or body on whose behalf an order for goods or services has been placed.

Payment of Invoices issued by the Association

You agree that on our acceptance of your application you, or your organisation will immediately become a TSA Member and will be entitled to all the benefits of membership (relevant to the membership you have applied for and subject to any restrictions which the TSA place) such that the membership service provided to you will begin at that time and before the conclusion of the seven day statutory cancellation period provided for under the Consumer Protection (Distance Selling) Regulations 2000 and that the seven day cancellation period ends on our acceptance of your application.

Unless a trade account facility is agreed, payment for all goods and services shall be payment received with order or against a pro-forma invoice.

Where a trade account facility is made available, the Seller’s normal trading terms are payment within 30 days from the invoice date, unless agreed otherwise in writing.

The Seller is a ‘small company’ as defined by The Late Payment of Commercial Debts (Interest) Act 1998. It will use the powers given to it under these Regulations to impose and collect interest penalties on overdue payments. Any such penalties will be calculated at 8% over the Bank of England Base Rate.

The Seller will allocate all payments received in the following order of priority: payment of any interest accrued on outstanding debts before payment of the principal of debts, starting with the oldest debt.

Goods are not tested or sold as fit for any particular purpose and any term warranty or condition express or implied or statutory to the contrary is excluded.

Under no circumstances shall the Seller’s liability (in contract, tort or otherwise) to the Customer arising under, out of or in connection with this contract or the goods supplied here under exceed the invoice price of the particular goods concerned.

The Seller shall be under no liability for loss damage or delay however arising caused by circumstances outside his control.

The title to any goods supplied by the Seller remains with the Seller until the debt and any late payment penalty has been paid in full. The Customer agrees that, prior to the payment of the whole price of any goods, the Seller may enter upon the Customer’s premises and remove the goods there from and that prior to such payment the Customer shall keep the goods separate and identifiable for this purpose.

All terms expressed or implied relating to the quality of goods are warranties only the breach of which give no right to reject the goods or terminate the contract in any circumstances whatever.

All prices quoted are exclusive of VAT where applicable.

The Seller will not issue receipts for payments made by cheque or bank transfer except in response to an explicit request.

Where these terms and conditions in any way conflict with any terms on which the Customer has purported to purchase the goods, then the provisions of any such terms of the Customer shall be deemed to be ineffective to the extent that they are inconsistent herewith.

Any provision herein set out shall, to the extent it would by virtue of the Unfair Contract Terms Act 1977 or similar enacted Legislation, Regulations or Directives, be of no effect against a person dealing as a consumer, not apply in respect of a sale to a person so dealing.

These terms cover the administration, payment and refund arrangements for applications for Membership of the Association.

Resignation Policy

Resignation from membership of the Association is required in writing and delivered to the Company’s registered address.

Payment of Membership Subscriptions will be sought pro rata for membership benefits received from the date of renewal to receipt of the written termination of membership.No refunds will be made on early termination of membership.

*Please ensure fields are completed