APPLICATION FOR MEMBERSHIP

Membership rates:

New member

Life member

£10.00

£200.00


I/We wish to apply for membership of the Society and have completed the banker's order form below


Name



Address




Postcode


Telephone(inc STD code)
& E-mail [optional]


Gift Aid Declaration: I do / do not [delete as applicable] want the charity to treat all donations I have made since 6th April 2000 and all donations I make from the date of this declaration as Gift Aid Donations. I do pay an amount of income tax or capital gains tax equal to the tax reclaimed on my donations and will inform the Society if I cease to pay sufficient tax.

Signed:



Banker's Order: [Do not detach] To: [name & address of your bank, including postcode]



Account Name
Bank sort code
Account number

.

.

.

Please pay account number 5982 8309 sorting code 09-01-51 of the Somersetshire Coal Canal Society at the Santander Bank the sum of £7.50 / £10.00 on the ....... day of ............month of 20.....and each year thereafter until further notice from my / our account specified above.

Signed



[Delete where applicable. Insert your choice of payment day, month and year - being at least 30 days ahead of the day you dispatch this application.]

TO BANK: When making payments please quote SCCS Membership Reference Number: .................................

When completed, please return this form to:
MEMBERSHIP SECRETARY - SCCS
36,Lower Whitelands, Radstock, Bath BA3 3JW
E-mail: membership[at]coalcanal.org.uk  

Return to home page