Annual Membership Form

Please fill out the form below and press submit. Thank you, we look forward to seeing you soon!

Title *

Full Name *

Email address *

Telephone Number *

Date of Birth *

Full Address (with postcode) *

How many are there in your household? *

What are the names and ages of any children in your household (if none write N/A)) *

Please fill out any dietary requirements for anyone in your household (e.g. Diabetic, Gluten free, Vegan etc.) if none type N/A *

Do you need us to make any reasonable adjustments within the shop for your or your family (e.g. wheelchair, walking frame etc.) *

Proof of address is needed, please upload this here: *

Please provide us with your consent to allow us to use your personal data within our group or to contact you with any special offers, take photographs, short videos as we may like to use these for marketing purposes to help promote us *

Yes
No

A quick question, why are you joining us, please tick all that apply *

To join our cooking classes
To join our talks and events
To access fresh food at our discounted supermarket
To combat loneliness
To meet new people
To access the kids club

Please transfer the £25.00 Annual Member ship fee to: Name: Kitchen Social & Cookery Club / Account Number: 00275651 /Sort Code:23-11-85. In the reference please state the following MEM/(your surname)/date (e.g. MEM/Smith/01/01/25) & enter the date below *

Annual Membership Form

Please fill out the form below and press submit. Thank you, we look forward to seeing you soon!

For any questions or queries, please contact us HERE