Membership Application

  I apply for membership of Lonsdale District Carers, I enclose membership fee £2.00

                                                                                                                 Donation £....................

                                                                                                                       Total £....................

  I declare that I am:

• A carer
• A former carer-my caring role ceased within the last two years
• A former carer-my caring role ceased more than two years ago
• A person interested in carers issues
• I am a taxpayer & eligible for Gift Aid.  I want to Gift Aid all donations I have made to the Lonsdale District Carers since the 6^th April 2000 and all future donations until I notify you otherwise.
• I am not a taxpayer

          Name.............................................

          Address...................................................................................

          Postcode.........................................

          Tel.  No............................................        Where did you hear about us?....................

When completed please return to:

Lonsdale District Carers,  Freepost, NWW3320A, Morecambe, LA3 1BR.

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