Join Our Branch

Becoming a Branch Member enables us to ensure you are kept aware of all our Branch organised activities, many of which are subsidised from Branch funds. As well as having access to our Branch website, members also receive our seasonal Branch Newsletter, either by email or paper copy updating members on what your committee are doing.

Individuals who are members of Parkinson’s UK do not automatically become Branch Members. Parkinson’s UK does not automatically assign you to a branch or join you into that branch.

Becoming a Branch Member is simple, and there is no membership fee (although you can make a donation to Branch Funds at any time!). Carers or other family members should join separately.

Please complete the online membership form below. Alternatively, if you wish a hard copy version of the membership form to complete and post, then contact our Secretary: Karen Young.

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Please indicate your status *

• Recently diagnosed with Parkinson's
• Have been living with Parkinson's for some time now
• Spouse / Partner
• Carer
• Family member
• Other

If Other, please explain

Year of diagnosis

optional

Title *MrMrsMsDrOther

First Name *

Last Name *

Address *

Postcode *

Contact Telephone Numbers *

Email Address *

Parkinson's UK membership number

(if known)

In Case of Emergency (ICE) *

Please let us know Name and Contact details of someone we can contact in case of emergency should we need to.

Happy to be emailed with updates *

• YES
• NO

Happy to be called on the phone

• YES
• NO

Wish to receive updates by Post ONLY

• YES

Please use this option only if you don't have access to the internet or someone who uses the internet for you .

Please let us know if you have any specific skills, perhaps from work, that you feel the branch could benefit from - for example, IT skills, event organising, etc. and are you happy to volunteer these skills.

Consent to publish *

• I give my consent for this
• I do not wish to give my consent for this

Please indicate above if you give us your consent to publish occasional photos taken during branch activities to promote Cirencester and Stroud Branch of Parkinson's UK. You retain the right to request removal from the website of such photos at any time.

Data Protection (GDPR) *

• I give my consent for this
• I do not wish to give my consent

I understand that my details will be held with Parkinson's UK head office and this branch committee so that we can send you branch activity and update information. I give my consent to this in joining the Cirencester & Stroud Branch of Parkinson's UK. For reference here is the link to GDPR Privacy Policy: https://www.parkinsons.org.uk/about-us/privacy-policy

Reason for Joining

Please let us know here why you wish to join, what you would like to participate in i.e. social activities, therapeutic activities, sport, other.

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