Name of Club

Name of Applicant (Club Contact)
 

Address 1 
Address 2 
Address 3 
Address 4 
Post code  Telephone
E- mail 
Website 
Affiliation number for Renewal

Nature of Disability, if any (optional)



Select Membership type: -

Club Affiliation Standard

£40

Renewal £40

Club Affiliation Premium

£100

Renewal £100

 

We would also like to make a donation of £ to help the NABD in it's work

Agree to Gift Aid Declaration. Please type YES into the box

I understand that application for Membership implies acceptance of the Constitution and Rules of the Association.

I enclose a cheque / PO made out to 'NABD' for £
Signature of Applicant                                       Date
Cheque / PO number

Please keep a copy of this form for your records.
Your application will be dealt with as soon as possible. Please allow 21 days.

Send this form to: Unit 20, The Bridgewater Centre, Robson Avenue, Urmston, Manchester. M41 7TE