Friends of the Lake District | Gift Membership (joint)

Details of person purchasing the gift: Title *

First Name *

Surname *

Your telephone number *

Details of people receiving the gift membership. (First Person) Title *

First Name *

Surname *

Date of Birth

Details of second person: Title

First Name

Surname

Date of Birth

Address *

Postcode *

Telephone number

Email address

Message to go with your gift membership (optional):

Is there a date you need the gift membership to arrive by? If so please write the date here:

Please tell us where you would like the membership pack sending: *

To my address so I can give it to themDirect to the gift recipient’s address

What prompted you to join?

Leaflet in Lakeland Walker Leaflet in Cumbria LifeArticle in the newspaperZipwire campaignPicked up a leafletFriends of the Lake District e-news

Other (please state)