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Supporting people affected by Charcot-Marie-Tooth disease.

Sign up to become a friend of CMT

Please complete this form to become a “Friend” of Charcot-Marie-Tooth UK.

We will keep this information on our database in order to administer our membership scheme, but please rest assured, we never sell data to third parties, nor do we ever indulge in “hard sell” fundraising.

On receipt of this form, you will receive some further information via email, and will be added to our e-mailing list in order to receive further updates and our magazine, ComMenT, regularly.

 

Title
First Name
Last Name
Email
Address line 1
Address line 2
Address line 3
City/Town
County
Are you outside the UK
Postcode
Country
Telephone
Mobile
Date of birth
   
You will also automatically be subscribed to our e-newsletter - you can unsubscribe at any time.
   
I am:
Type of CMT
Would you like to be in touch with the nearest local group to you, (if there is one)? If you consent to this, your basic contact details (address, email, telephone) may be shared with our authorised group leaders.

 

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