SYMBA Membership form - 2018/2019
Please complete this form to join South Yorkshire Multiple Births Association.
Is this membership
Your surname *
Your answer
Your first name *
Your answer
Occupation *
Your answer
Your email address *
Your answer
Please re-enter your email address *
Your answer
Your partner's full name (if applicable)
Your answer
Partner's occupation
Your answer
Partner's email address
Your answer
Please re-enter your email address
Your answer
House number or name *
Your answer
Street name *
Your answer
Area *
Your answer
Town/City *
Your answer
Postcode *
Your answer
Mobile telephone number (just one telephone number please) *
Your answer
Date of birth of multiples, or due date *
Please enter the date like this --/--/-- eg 28/07/2011
Your answer
First names and surname of multiples (if applicable) *
Your answer
Dates of birth and names (including surname) of any siblings *
Please enter date like this --/--/--
Your answer
Do you have a Facebook account? (We have a very active community on our secret Facebook page) *
Name of your Facebook account (and your partner's if applicable)
Your answer
We take photos at our events to post on our Facebook page as well as our website. Are you happy for your family to be included in them? *
The photos will be used for club purposes only and will not be passed onto any third parties.
How did you hear about our Club? *
Your answer
Would you be interested in helping to run the Club? *
We are always looking for people to join our Club's committee. If you want to help but don't want to join the committee we'd still like to hear from you. Please detail below any interests you have, skills or experience which you think might be helpful for the Club.
Would you like to make a donation towards the Club's running costs? *
Our Club does not have any funding, and therefore we rely on donations from members and local businesses. We are very appreciative of any donation, however small. We will contact you if you are able to make a donation - thank you.
Do you have any questions, suggestions or comments for the Club?
We are always interested to hear from our members. Please feel free to give us any feedback (good or bad). We also like to hear about any ideas our members have.
Your answer
By completing this form you confirm that South Yorkshire Multiple Births Association can hold information about you and your family. This will not be used for any purposes other than for the running of the Club. *
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