Pupil First Names/Last Name *

First Name

Last Name

Older Brother at school? *

Yes

No

Parent/Carer 1 Name *

First Name

Last Name

Family or Parent/Carer 1 Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Carer 2 Name

First Name

Last Name

Parent/Carer 2 Address - (If different)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Is separate correspondence required *

Yes

No

Do you agree (by clicking yes) that the details on this form can be held on computer and used solely by the RSPA? *

Yes

No

Membership Payments *

Paying online full membership of £50

Paying online Sixth Form (Year 12) full membership of £20

Paying by cheque full membership of £50

Paying by cheque Sixth Form (Year 12) full membership of £20

Paid already - Sibling in school

Please confirm which applicant is making a claim for Gift Aid? *

Parent/Carer 1

Parent/Carer 2

Neither

Please treat the current membership donation as Gift Aid *

Yes

No

Please treat my past (from the last four years) donations as Gift Aid *

Yes

No

Please treat my future donations as Gift Aid *

Yes

No