Membership Subscription for Myotonic Dystrophy Support Group

The annual subscription fee is £15 per person or £15 for a family living at the same address.

The Myotonic Dystrophy Support Group is a charitable company (Company number 07144171), which is registered with the Charity Commission (1134499).

Company Members must be 18 years or over pay the annual subscription fee. They are entitled to receive notice of members meeting attend those meetings and vote. Any director of the Company must be a Company Member. If you are over 18 years old and would like to be a member of the Company please read the following statement.

“I agree to become a member of the Company and agree that if I am asked I will pay a maximum of £1 towards the winding up costs and any liabilities of the Company.”

Your Details

Title*

First Name*

Surname*

Email*

Telephone Number*

Address*

Town*

Post Code*

Do you have DM?*

Date of Birth dd/mm/yyyy*

Family Member 2

Name

Do they have DM?

Date of Birth dd/mm/yyyy

Family Member 3

Name

Do they have DM?

Date of Birth dd/mm/yyyy

Family Member 4

Name

Do they have DM?

Date of Birth dd/mm/yyyy

Family Member 5

Name

Do they have DM?

Date of Birth dd/mm/yyyy

Please treat the gift of money that I make today and all future gifts of money as gift aid donations. I declare that I am a UK taxpayer and understand that I must pay UK income tax/or capital gains tax in each tax year at least equal to the amount of tax that the charity will reclaim.

Please treat as Gift Aid according to the terms above

*I agree to the membership terms and conditions

*Membership, please confirm

Once you have completed the form and click the box below for the anti spam verification. Press the Submit Button to take you to the payment page and press Pay Now.

Membership Subscription for Myotonic Dystrophy Support Group

Your Details

Family Member 2

Family Member 3

Family Member 4

Family Member 5

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