Membership Form - Down's Syndrome Scotland

Membership type

Life membership

Your details

Name*

First Last

Email*

Mobile number

Landline number

Address

Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Your Local Authority

Do you live with your family or independently?

I live with my family

I live on my own/independent

Other info

Date of birth

We will use the information you have put on this form to let you know about what we are up to and contact you about the support we can offer you. If you have any questions about this please call us on 0300 030 2121.

How would you like us to contact you?

Please tick as many as you like

Phone

Post

Text

Declaration

I’ve not been refused membership to any other charitable organisation

I’ve not had membership with any other charitable organisation revoked for any reason

I would like to become a member of Down’s Syndrome Scotland and I hereby declare that by making this application and clicking on ‘Join us now’ below, I declare the following:

Paid membership

We are delighted you are renewing your membership to Down’s Syndrome Scotland. Please enter your details below and you will be taken to the payment completion page. If you are a family on low income please contact our office directly on 0300 030 2121 or email finance@dsscotland.org.uk

Title

Name*

Job title

Email*

Mobile number

Landline number

Address

Address*

Street Address Address Line 2 City County ZIP / Postal Code Country

Your Local Authority

Family membership additional info

Person with Down’s syndrome

First name of person with Ds*

Last name of person with Ds*

Relationship to person with Ds

Date of birth

School name

Professional membership additional info

Please fill out the following additional information as applies to your organisation. This will help us target relevant information

Operates locally/nationally

Operates Locally

Operates Nationally

Keeping in touch info

Keeping in touch

In addition to receiving your membership communications, we would like to send you information about the work we do, ways we can support you and you can support us. As well as sharing news about the charity and your local branch, we will contact you about any of our services that may be of interest, events and fundraising for DSS, our campaigns and the many ways you can shape our work.

We will ask you these questions each time you complete a form to make sure we always have your latest preferences – so if you wish to keep hearing from us, please opt-in each time.

Please contact me via:

Phone

Text

If we have your postal address, we may contact you by post unless you tell us otherwise.

We take your privacy seriously and promise to never sell your data. You can find out more about your rights, how we use your personal information and how we keep your details safe and secure by reading our Privacy Policy. For more information, or to change the way we contact you, please e-mail info@dsscotland.org.uk or call our team on 0300 030 2121.

Gift Aid

I want to Gift Aid my donation and any donations I make in future years or have made in the past 4 years. I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all donations in that tax year it is my responsibility to pay any difference.

Gift Aid

I am a UK taxpayer

I am not a UK taxpayer

Declaration I would like to become a member of Down’s Syndrome Scotland and I hereby declare that by making this application and clicking on ‘Join us now’ below, I declare the following: