To Join Mutual Support

Membership of Mutual Support is open to serving and ex-serving members of the Armed Forces and Reserves, their dependants and carers affected by MS. There is no charge to join and no membership fee.

Membership Application

Please ensure this form is filled in by or on behalf of the person with MS, or that the person with MS is listed as the main member.

Full Name: *

Full Name of partner: *

Please list all dependant children under 18 years of age, with their date of birth

Address: *

Telephone Number: *

Email address: *

Newsletter by E-mail: *

The following questions are for the person with MS:

Are you still Serving?

Service number:

Service:

Regiment if applicable:

Do you belong to a Service Association:

If you belong to a Service Association, which one:

If Not Still Serving, when did you retire:

New Member:

Are you in receipt of a WP or AFCS award?

Is the person with MS a dependant?

Date of diagnosis?

Date of first symptoms of MS?

Are you in receipt of DLA?
 Yes No

How did you hear about Mutual Support?

Quick Sum:
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