Member Registration - Arthritis Action

Title*

Name*

First Last

Date of birth*

Date Format: DD/MM/YYYY

Home Telephone

Email*

Mobile

Address*

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

Membership Options*

Annual
Lifetime Membership

*Annual - £20.00 per year or £15.00 per year if you pay by Direct Debit
* Lifetime Membership - £100.00

How would you like to pay?

One off Payment
Direct Debit

One off Payment

Optional Donation

Please enter an optional donation amount here

There is no obligation to make a donation although a voluntary contribution will help the charity to reach more people with arthritis.

Gift Aid

Yes, I am happy for all gifts of money that I have made to Arthritis Action, past, present and future to be treated as Gift Aid donations

I confirm I’m a UK taxpayer and have paid sufficient tax (income and/or capital gains tax) on all my donations to all charities and CASCS to cover the tax that will be reclaimed on my donations. I understand other taxes such as council tax and VAT do not qualify

Total Amount Payable

Price: £ 0.00

I am becoming a member of Arthritis Action because

How did you hear about Arthritis Action?**

Data Protection Policy

In accordance with the General Data Protection Regulation 2018 we ask that you complete this form so we may process your information in a way that will best help you. You can read the full Policy here.

I would like to be contacted by (tick all that apply):

post
email
telephone
SMS

May we leave a voicemail to the numbers you've provided?

Yes
No

To receive news/information about (tick all that apply):

Research
Volunteering/Fundraising
Special Offers
E-mail newsletter

Account Name*

Sort Code*

Account Number*

Total Annual Fee

Total Annual Fee (Direct Debit)

Total Lifetime Membership Fee

One Time Fee for Donation

Price: £ 0.00

Are you Human?

Membership Type

Password

Enter Password Confirm Password

hidden_pass_field

Disclaimer: By signing and clicking submit below, you agree to the terms and conditions of our GDPR Policy.

Email

This field is for validation purposes and should be left unchanged.