DNA Membership Suspension Form

Entries marked with * are mandatory.

This form must be completed by the member or a parent/guardian.

Information

Direct Debit members
We can suspend your membership for £5 per month. Suspensions can only take effect from your next payment date (5th) to a future payment date (5th). For example, if you suspend from the 5th March for one month, your suspension will end on the 4th April, and your normal direct debit payment will resume on the 5th April when your membership re-starts

We require a minimum of 10 working days’ notice to action a suspension. Your membership and direct debit payments will resume immediately after the end of your suspension date. If you need to extend your suspension you must complete another form 10 days prior to the end of your suspension.

Annual members
There are no fees to pay to suspend an annual membership.

Your Details

Membership Number *

Name *

Address *

Postcode *

Telephone *

Suspension Details

Please help us by stating your reason for suspending your membership:

Work
Pregnancy
Medical
Other

Please help us by stating your reason for suspending your membership:

I wish to suspend my membership (must be from a payment date to a payment date). Please note memberships cannot be suspended retrospectively

With effect from the 5th of: *

Until the 4th of: *

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