Community Supporter membership form

Organisation Name Please enter the Organisation's name.

Primary online presence e.g. website; social media page Please enter the Organisation's primary URL.

Organisation Address Please enter the Organisation's address.

Organisation Postcode Please enter the Organisation's postcode.

Title Please enter the organisation contact's title.

First name(s) Please enter the organisation contact's first name.

Surname Please enter the organisation contact's surname.

Job title Please enter the organisation contact's job title.

Email address Please enter the organisation contact's email address

Telephone number Please enter the organisation contact's telephone number

Membership type

Membership Subscription Select your Membership Subscription amount...£40£75£100Other (enter below) Please select a Membership subscription amount.

Membership Subscription (Other) £ Please input your Membership Subscription (must be £40 or more).

Payment method Select your preferred payment method...PayPalBank TransferChequeTelephone Please select a Payment method.

I would like:

A PDF copy of our quarterly magazine, Yorkshire Dales Review sent to my emailA printed copy of our quarterly magazine, Yorkshire Dales Review sent by postPlease send me an additional printed copy of our quarterly magazine

I confirm this organisation supports the charitable objectives of the Friends of the Dales