Member Area Deferred Fee Request * Preferred Name Given Name Surname *Please describe the reason you are requesting to have your Membership Fee deferred. Example: I had an unexpected dental bill and do not have sufficient funds, in my account, to cover the direct debit, until my next pay day"Contribution*Please select the amount that you are able to contribute to your membership FeePlease SelectI cannot contribute to my Regular Fee$10.00$20.00$30.00$40.00*Date of deferred Regular Fee. DD MM YYYY *Please select the date by which you will pay your Regular Fee. (maximum 12 weeks from the date your fee was due to be charged) DD MM YYYY *I confirm The Deferred Fee Request is being made at least 7 days before the fee was to be charged