Membership Form

If you would like to become a member of the Friends of St Monica’s Hospital, please complete the form below or download and return our Membership Registration Form.

The security of your information and your privacy is important to us. We will never sell your information or share your information with any third party for them to process. We will always hold and process your data in compliance with the General Data Protection Regulation (EU) 2016/679. View our Privacy Policy.

We regret that only people over the age of 18 can register.

Membership Form

Name *

Address *

We would like to contact you in the future with news about The League of Friends of St Monica’s Hospital, Easingwold (FOSMH). We will only do that with your express consent. Your consent can be withdrawn at any point by contacting Angela Bussey, Secretary, either by emailing [email protected] or writing to The Friends of St Monica’s Hospital, Long Street, Easingwold, York, YO61 3JD.

Email *

Phone Number *

I am a registered patient at:

Do you have any accessibility requirements you would like to tell us about? such as special requirements regarding documentation or support with communications?

Please tick to indicate how you would like to receive information about membership and news and updates about the The Friends of St Monica’s Hospital, Easingwold. You can choose more than one:-

I would like to be contacted by:

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