DNA Membership Cancellation Form
This form must be completed by the member or a parent/guardian.
Information
Please be aware that early termination of a contract will incur a cancellation fee.
May we remind you that instead of cancelling your membership you could simply suspend it for a minimal charge of just £5 per month – this means that should you wish to rejoin our DNA scheme in the future you would not incur the usual joining fee. Please fill in a suspension form if you want to action this.
Your Details
 Membership Number
 Name
 Address
 Postcode
 Telephone
 Email
DNA Feedback
Please tick all applicable boxes, if stating ‘other’ please specify.
 Primary DNA site visited:



 Main DNA activity used:



 Additional comments:
Data Protection
We will use the information provided by you to respond to your enquiry. The basis under which the Council uses personal data for this purpose is that you have given your consent to the processing.

The Data Controller is Gedling Borough Council, Civic Centre, Arnot Hill Park, Arnold, Nottingham, NG5 6LU. You can contact the data protection officer at the above address or by email at dataprotectionofficer@gedling.gov.uk

Further information including how long we retain your data, who we share with and your rights can be found in our privacy notice