Darlington Association on Disability
20-22 Horsemarket, Darlington DL1 5PT
Registered Charity No. 518265

MEMBERSHIP APPLICATION FORM
 
Annual Membership Subscription 2007 = £10.00
(please make cheques payable to Darlington Association on Disability)



Name…………………………………………………………………………………


Address………………………………………………………………………………


…………………………………………………………………………………………


SIGNATURE…………………………………………


DATE………………………...


How did you hear about D.A.D.?..................................................

Darlington Association on Disability will record your details in accordance with its confidentiality policy. 

D.A.D is registered under the Data Protection Act.


Please return this form, together with payment, to our office 
(no stamp needed)

F.A.O. Stacey Allan
Darlington Association on Disability
FREEPOST NEA10018
DARLINGTON
DL1 5BR