Subscription Renewal/Application 2008 Form

If you click the Gift Aid box:  your subscription will be worth a lot more. To qualify for Gift aid, the amount you pay in income/capital gains tax must cover the amount we will claim from the Inland Revenue(£2.82 on each £10 worth of subscription).
http://www.hmrc.gov.uk/charities/donors/gift-aid.htm
Please visit note on British Dyslexia Association Constitution
Please fill in the details marked with a * ,print out and return to:
Membership, The Roy Fletcher Centre, 12-17 Cross Hill,
Shrewsbury, Shropshire SY1 1JH
First Name
*

Surname
*

Address line1
*

Address line2

Address line3

Post Code     Tel No(+code)
* *

Are you renewing? or joining as a new member?

Fee Type(click box)
-Individual/Family £20  -School £35;-Concessions £10

Cheque No:...........................Payable to SDA

Signed:.................................................... Date:................
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NB Subscriptions are half price if joining takes place between June-December.

To assist us in providing an efficient and relevant service, and also to give us general membership classification figures that we can use for our lottery bid, we would ask you for the following information:
Dyslexic Member-Child  -Adult
-Male  -Female -Age

School attended/Occupation:.....................................

Hobbies/Interests:.........................................
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