Friends of Durlston > How to Join > Application form

Friends of Durlston - application form

Title
First Name
Surname
or names for household members
Address
Telephone No.
Email
Vehicle Registration
2nd registration for Households
Membership number (if renewing)
 
Would you like to join as an
Individual £15
Household £20
 
If you would like to give an additional donation ?
£
 please say how much
Gift Aid
Tick here if you want to use Gift Aid and make your donation worth even more. For every pound you give, we will receive an extra 28p from the Inland Revenue. (To qualify for Gift Aid the amount you pay in income tax or capital gains tax must be at least equal to the amount we will claim in the tax year.)
I would like to be added to the Durlston mailing list