Application form for Existing Members to
become Beneficiaries

If you are already a member of LGF and would like to take out an additional membership, which covers you as an individual in the event of an unexpected illness or injury, please complete and submit the short form below.

(If you have your LGF membership number to hand, please provide it to help process your application)
DD slash MM slash YYYY
If you are under the age of 65 clicking Submit authorises Lady Grover’s Fund to collect by Direct Debit an extra subscription based on your age. This is in addition to the existing subscription paid on behalf of your oldest existing beneficiary. This first subscription payment will be pro-rata to align your future payments with your current renewal date. If you are aged 65 or over, we will contact you by email to confirm the amount of the back-payment you will need to pay for the intervening years’ subscriptions since you turned 65 before we take the extra Direct Debit payment. You can find more information and an estimate of this amount here: