Membership Support | ChAPS covers Cheshire

Adult Membership - Sign Up

Adult Membership is for autistic adults who are seeking support for themselves, with no autistic dependents.

You may have a diagnosis, or be awaiting an assessment - either way, ChAPS are here to offer support, advice and guidance.

£5 per month suggested donation.

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Adult Membership

Title:

First Name:

Last Name:

Address Line 1:

Address Line 2

Town/City:

Postcode:

Phone Number

Mobile Number:

Email Address:

Diagnosis:

Please include any further information you'd like us to know regarding your membership

Opt-In

I have read the ChAPS Privacy Notice and consent to my data being held and processed as outlined.

Gift Aid Declaration

To help with funding all our numerous activities we also ask members who are UK Taxpayers to sign up to Gift Aid their donations. By ticking this box, you agree to Gift Aid your current donation and any donations I may make in the future or have made in the past 4 years to Cheshire Autism Practical Support. I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference. Please notify ChAPS if you want to cancel this declaration, change your name or home address or no longer pay sufficient tax on your income or capital gains.

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0344 850 8607

info@cheshireautism.org.uk

ChAPS Autism Ark, Yarwoods Arm, Navigation Road, Northwich, CW8 1BE

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