NAGS registration form Member Form 2023 Subs Basic Annual Fee 23 (excl discount and benevolent) Do not include the £ New Member 2023 Yes Benevolent Contribution 23 Do not include the £ Discount amount 23 Do not put the £ Date of annual payment (2023) Annual payment collected amount (2023) Jan monthly amount collected 23 Feb monthly amount collected 23 March monthly amount collected 23 April monthly amount collected 23 May monthly amount collected 23 June monthly amount collected 23 July monthly amount collected 23 August monthly amount collected 23 Sept monthly amount collected 23 October monthly amount collected 23 Calculated monthly collected 23 Date Retired 23 2022 Subs Basic Annual Fee (excl discount and benevolent) Do not include the £ New Member 2022 Yes Benevolent Contribution Do not include the £ Discount amount Do not put the £ Date of annual payment (2022) Annual payment collected amount (2022) Jan monthly amount collected Feb monthly amount collected March monthly amount collected April monthly amount collected May monthly amount collected June monthly amount collected July monthly amount collected August monthly amount collected Sept monthly amount collected October monthly amount collected Calculated monthly collected Date Retired 2020 Payments NOV Amount DEC Amount JAN Amount FEB Amount MAR Amount APR Amount MAY Amount JUN Amount JUL Amount AUG Amount SEP Amount OCT Amount 2021 Payments NOV 20/21 Amount DEC 20/21 Amount JAN 21 Amount FEB 21 Amount MAR 21 Amount APR 21 Amount MAY 21 Amount JUN 21 Amount JUL 21 Amount AUG 21 Amount SEP 21 Amount OCT 21 Amount Title MrMrsMissMsDrProf First Name * Surname * Telephone: Email * Gender * Female Male Address * Address Address Address City City County County Post Code Post Code Region * England: CentralEngland: East AngliaEngland: East MidlandsEngland: NorthEngland: North EastEngland: North WestEngland: South EastEngland: South WestEngland: West MidlandsNorthern IrelandWales: North WalesWales: South WalesScotland: North ScotlandScotland: South Scotland Office/Agency Name * Membership Type CommissionedSalariedAssociateRetired Annual Membership Fee (£) Monthly Membership Fee This is paid over 10 months Jan-Oct Payment Plan (Annually/Monthly) * Annually Monthly Benevolent Fund Contributions (Yes/No) Yes No £10 per year Gift Aid (Yes/No) Yes No Next
