Friends of the Lake District | Joint Life Membership (over 65s)

Title *

First name *

Surname *

Date of birth *

Address *

Postcode *

Telephone number *

Additional telephone number

Email address *

Confirm email address *

Can we claim gift aid on your donation? Tick here if you are a tax payer and would like us to reclaim the tax on this payment. *

YesNo

Partners gender *

MaleFemale

Partners first name *

Partners surname *

Can we claim Gift Aid on your donations?

YesNo

Name of Joint Member we can claim Gift Aid against?

Why do you want to be a part of protecting the Lake District?

I love walking in the Lake DistrictI regularly take holidays in the Lake DistrictI have supported Friends of the Lake District for a while and its about time I joined!I want to support the campaigning aspect of protecting the Lake DistrictI am a Cumbrian resident

Other reason for wanting to be a part of Protecting the Lake District (please state)