The Heavitree Practice

Online mebership form

Friends of the Heavitree Health Centre Membership form

You are invited to become a Member of “The Friends of Heavitree Health Centre”.

By joining and renewing annually you will help the Friends to continue to develop and extend the range of services which we provide for the local community. The suggested annual donation is £5 per person.New paragraph

Membership form

As a “Member of the Friends” you could help the Charity by taking part in any of the following: Please tick if any would interest you.

Attending or organising fundraising activities (approved by the Friends)

Donating items for sale in the shop

Provide prizes for any draws or raffles organised by the Friends

To consider leaving a donation to the Friends in memory of a loved one

Title

Name:

Address

Email:

Phone:

Phone (mobile)

Your £5 annual subscription can be Gift Aided so if you are a taxpayer please tick the box to enable us to we claim back 25% of your donation.

I am a UK taxpayer and I want the Friends of Heavitree Health Centre to treat all donations as Gift Aid donations until I notify you otherwise.

Data Protection

I agree to the Friends storing my contact details in their records for the purpose of communication with me by post, telephone, or email.

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