Welcome to the Adventist Special Needs Association

Please use the following form to join ASNA online.

• If you do not like, or find using online forms difficult you can also;

Download a Word document form (.doc), fill it in via computer and sent it to us at: ASNA (Membership), Suite W-05, Windrush Innovation Centre, Howbery Park, Wallingford, OXON, OX10 8BA

Download a PDF membership form, print it out and send it to us at:ASNA (Membership), Suite W-05, Windrush Innovation Centre, Howbery Park, Wallingford, OXON, OX10 8BA

• If you would like this information in an alternative format (large print, braille, audio etc) please also contact us.
1. Membership details

1. Full Name
2. Full Address
3. County
4. Post Code
5. Telephone (inc. area code)
6. Mobile Number
7. Email Address(valid email required)
8. Denomination or church name
9. What church do you attend?
10. If you found us at a conference, please state which one

2. About your membership - A

1. Do you or anybody in your family have a special need or disability?
2. yes no
3. If yes please give details
4. Are you the person with a disability?
5. yes no
6. What is your date of birth?
7. What is nature of your disability?
8. 3. About your membership - B
9. Are you the carer of the person with a disability?
10. yes no
11. If yes please give details
12. Name of person with a disability
13. Their relationship to you (e.g. son, mother etc)
14. What is their date of birth?
15. What is the nature of their disability?

Section 4

1. Are you a professional working in special needs/disability area?
2. What is that nature of your work? (Please identify area and skills)

Section 5

1. Please tell us your reason for wanting to join ASNA
2. Please tick the boxes to tell us how you found us
3. Your church A conference Word of mouth Internet Other
4. If other please state

Membership fees - (updated September 2009)

1. Membership Fees are as follows:
2. £5 for individual membership over 16 years
3. Free for children under 16 years old
4. Please confirm how you will pay
5. I enclose an optional donation of £
6. Name
7. Date
8. Please tick here if you would like ASNA to reclaim the tax you have on your donation

 

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