Thank you for purchasing a membership

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If below 16, name of responsible adult, please put n/a if not applicable (required)

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Do you consider yourself to have a disability? please select the correct option
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If yes to either of the questions above please give brief details, including any mobility aids used.

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Membership required please select the correct option (associate = family member or carer/pa of disabled person)
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Previous membership please select the correct option
New MemberRenew existing membership

If renewing membership please state your previous membership number, it starts LDSA10 and can be found on your most recent card

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I have read and agree to the rules set out in the LDSA constitution Read Constitution

The send button below will only become active once all questions are fully completed, please ensure you have chosen the correct options.

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