Membership of Mutual Support is open to members of the Armed Forces community – serving men and women, veterans, and their dependants affected by MS. There is no charge to join and no membership fee. Please read our ‘Privacy Statement’ before entering your details.

*For the purposes of membership, a dependant is defined as a cohabiting partner or child under 18 who is in full-time education
**The person with MS is the primary member.
***Please fully complete to avoid delays in your application

Membership Details

Please list the person with MS as the main member

Member Title *:

Member First Name *:

Members Surname *:

 
Date of birth *:

 
Partner / spouse details *:
Title *:
First Name *:
Surname *:
 
Address *:
 
Telephone Numbers
Home *:
Mobile:
Email Address *:
 
Allow us to contact you via email?
Regarding Membership?
YesNo
 
Newsletter
YesNo
(E-mail is the preferred option but we can send a hard copy if you are not able to use a computer)
 
Date of diagnosis *
Date of first MS symptoms *
 

Service Information

Are you: (RN, Army, RAF, Reservist - Serving, Veteran, Dependent) *

Royal Navy (RN)ArmyRoyal Air Force (RAF)ReservistServingVeteranDependant

 
Service Number (if applicable):
Date of enlistment (if applicable):
 
Rank/Discharge Rank (If applicable):

If not still serving, when did you retire (If applicable):

 
Date of Discharge (If applicable):

Were you medically discharged from HM Forces (If applicable):
YesNo
 
Is or was your partner serving/veteran?
Royal Navy (RN)ArmyRoyal Air Force (RAF)ReservistNo
 

Medical Information

Date of first MS symptoms:

Date of Diagnosis:

 

Financial Information

Are you in receipt of a War Pension or AFCS award?

YesNo

If you are Serving/Veteran what Armed Forces Pension Scheme applies to you?

 
Are you in receipt of benefits: PIP/DLA/ESA/UC/AA/OTHER?

PIPDLAESAUCAA

If other, please specify:

 
 

Mutual Support Privacy Statement

When you join Mutual Support, we will collect certain sensitive data including: Names, DOB, Address, Email, Telephone, Mobile and Service Details. We promise we will only use this information in relation to your membership, and will not divulge your details to any external source without your permission.

The Society’s Privacy Statement explains how we protect your privacy and how you can control how we use your personal information.

You can read the full statement at – https://www.mssociety.org.uk/privacy

You have the right to view and review what information we hold about you at any time or change how we use it, simply email adminvolunteer@mutual-support.org.uk with your request.

If at any stage you no longer wish to be a member of Mutual Support, please send an email with the word ‘UNSUBSCRIBE’ to membershipvolunteer@mutual-support.org.uk

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