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?

What prompted you to join?

Leaflet in Lakeland Walker Leaflet in Cumbria LifeArticle in the newspaperZipwire campaignFriends of the Lake District magazineFriends of the Lake District e-news

Other (please state)