Couple Members
Title
Mr.
Mrs.
Miss.
Ms.
Mx.
Dr.
Rev.
Prof.
Cllr.
Lady
Lord
Dame
Sir
Name
Second Title
Mr.
Mrs.
Miss.
Ms.
Mx.
Dr.
Rev.
Prof.
Cllr.
Lord
Lady
Dame
Sir
Second Name
Address
Address (second line)
Town/City
Country - we assume it is UK?
Postcode
GiftAid - Boost our coffers by 25%
Yes, I am a UK taxpayer and would like you to reclaim the tax on membership costs. Treat as donations, with any future donations, until I notify otherwise. I understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.
Phone
Alternative Phone
Cardholder Name
Email
Credit or debit card
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