Print this page and return the completed
form to:
SCuDA Administrator Dawn Elsworth
C/O Alfred Barrow School,
Duke Street,
Barrow-In-Furness.
LA14 2LB
Barrow Centre: Tel/Fax 01229 820998
Kendal Centre: Tel: 01539 742632
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If you are a parent of a dyslexic child, or have a child you think may be dyslexic may we have : Child's Name.......................................................... Date of Birth...................................... |
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I enclose a cheque for £11 ( made payable to SCuDA)
Signed......................................................................................................... Date ..................................
When you join we will send
you details of Gift Aid
(This will make your subscription worth £3.08 more to SCuDA)
Registered Charity No 511311
The information that you provide on this form will be processed by SCuDA and
will be used for: