SOUTH HAMS SOCIETY
APPLICATION FOR MEMBERSHIP
Please
print out this form and return it to the Membership Secretary: Mrs. Nicola
Fox, 32 Ebrington Street, Kingsbridge, TQ7 1DE, tel. 01548 856510
together with your subscription or completed standing order. Membership subscription:
£10 p.a.
Surname……………………………………….
Initials ………….….Title…………………
Address ………………………………………………………………………………………
…………………………………………………Postcode
……………………….
Telephone number(s) ……………………………………
E-mail address ………………………………Parish
(in S. Hams) ………………….
INTERESTS - please tick as appropriate
__Farming __Fishing __Trees & Hedges __Environment __Transport __PIanning
__Footpaths & Bndleways __Historic Buildings __Local History __Other (please specify)
Are there any skills you could offer the Society - e.g. planning, legal, environmental, newsletter contributions etc.?
I/we wish to become a member of the South Hams Society and agree to its aims and objectives.
Signed…………………………. Date………………………..
I enclose my subscription
of £…….. (cheque/postal order/cash) or I have signed the
Bankers Order (Please
delete as
appropriate)
GIFT AID DECLARATION
I am a UK taxpayer and wish the South Hams Society to reclaim tax on all my annual subscriptions and donations.
I must pay an amount of income
tax and/or capital gains tax at least equal to the tax that the Society reclaims
on
my donations etc. in the tax year (currently 28p for each £ of the subscription
or donation made).
I understand that I can cancel this declaration at any time by notifying the Society.
Signed………………………….
Date …………………
-------------------------------------------------------------------------------------------------------------------------------
BANKERS ORDER
(Please return to the Membership Secretary, at 32
Ebrington Street, Kingsbridge, Devon TQ7 IDE,
and not to your Bank)
To ………………...................Bank plc
Address …………………………………………………………………………………………………..
Please pay now to the National Westminster Bank Ltd., Kingsbrldge, Devon (53.61.37)
the
sum of …………………………
to the credit of the South Hams Society a/c no. 08607397 and on the 1st January
each year hereafter the sum of …………………..and
debit to my account …………………………….(a/c
no ).
Please cancel all previous orders in favour of the South Hams Society.
Name and Style………………………………………..
Address ……………………………………………….
Postcode ……………………………………………..
Signed ………………………………………………..
Date………………………………………..
