Data Disclosure Authority form

If you need any assistance whilst filling out this form please contact Membership Admin on 020 8548 7093

Under the Data Protection Act 1998, I (Name)

Of (Address)

With a date of birth of

and National Insurance Number of

hereby grant complete authority for Blesma The Limbless Veterans and its Nominated Agent(s)

to act on my behalf to receive personal and confidential information from*

on the subject of**

Name

Date

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Blesma The Limbless Veterans is committed to safeguarding your personal information. Your personal data is protected by UK Legislation, specifically the Data Protection Act 1998, the Electronic Communications (EC) Directive 2003 and the General Data Protection Regulation (2018). We aim to exceed our obligations by following best practice and reviewing our procedures regularly.