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MEMBERSHIP APPLICATION

Please complete this form and send it to:

The Membership Secretary,
Wilts & Berks Canal,
16 Firham Park Avenue,
Romford,
Essex
RM3 0SJ. 

I/We wish to apply for membership of the Wilts & Berks Canal Trust and agree
to be bound by the provisions of its Memorandum and Articles of Association. 

Name:

Address:

 

Tel:                                                           

E-mail:                                                                    

Age (if under 18):   

Skills offered:

Which branch do you wish to join:  Cricklade

MEMBERSHIP FEES (Tick as appropriate)

Standard (one copy of Dragonfly, one vote) £10.00          
Senior Citizen/Concessionary £5.00  
Junior (under 18) £5.00  
Company Rate £25.00  
Family (two adults at one address) + Juniors £15.00  

N.B. Family rate allows one copy of Dragonfly and two votes at an AGM
or EGM. Life membership is also available. Please enquire for details.


Voluntary Donation  £………………    Total Enclosed   £………………

(Cheques Payable to The Wilts & Berks Canal Trust)

 

Signed…………………..…………………….…..Date…………….………..

 

GIFT AID DECLARATION

If you pay Income Tax or Capital Gains Tax, you can make your subscription
worth more to the Group by signing a Gift Aid Declaration. This does not
cost you any extra but you must already pay an amount of tax at least equal
to the tax we reclaim on your donations - Please let us know if you cease to pay tax.

I am a U.K. taxpayer and wish the charity to treat all my subscriptions and
donations from the date of this declaration as Gift Aid Donations.

 

Signed…………………..…………………….…..Date…………….………..

 


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Last modified: 13/01/2006.