ASNA membership renewal

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Please use this form to renew your membership with ASNA. For new membership, please use the new membership form. This form can be downloaded at www.asna.info/join the form below. ASNA annual subscription is £20.00 per year. This is an annual subscription for all adults. All children under 16 have free membership. All details will be used for ASNA purposes only. What do you get for your membership subscription?: 1. Discounts for all online services. 2. Some discounts for resources purchased online 3. Discounts on all ASNA events.

Email *

Title *

Mrs.

Master

Other:

FIRST NAME *

SURNAME *

Postal Address

I am a member of ASNA (if no, please fill in a new membership form here www.asna.info/join) *

Yes

Other:

Please tick the relevant areas *

I am a carer

I have a disability

I am a supporter of ASNA

Patron level Bronze

Patron level Silver

Patron Level Gold

Patron Level Platinum

Required

Please indicate below any changes that have been made to your details since joining ASNA such as your address, telephone number email address. *

I would like to renew my membership. I will make a payment into the ASNA account on the date indicated below (please let us know when the payment will be made so we can look out for it). Please write the date below *

YYYY

Please indicate below any further donation you would like to make to ASNA and how you would like to make this contribution (please tell us how much) *

How will you make this donation

Bank deposit

Cheque

Paypal

other digital platform

Other:

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Have you considered making a regular subscription to ASNA? Here are the details: With online banking, check regular standing order to the following bank account: Account Name: ASNA Bank, BANK, Lloyds Bank Account Number: 03151450, Sort Code: 30 91 53. Please use your name as a reference. *

YES I will make a regular payment

Please send more information about how to make the regular payment

I would prefer to make a large lump sum payment into the ASNA bank account

Other:

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