Membership Application Form

I apply to become an * .........................................member of The Bristol and Gloucestershire Archaeological Society, and wish/do not wish (delete as required) to receive the publications of the Gloucestershire Record Series.

Block Capitals please

Name and style .........................................................................................……...

(including honours, degrees and qualifications)

Full address ..............................................................................................………

.................................................................................................................……….

..................................................................................................................……….

Telephone number ................................ Signature ..................................………

Please treat all donations (including membership subscription) I may make to the Charity from now on as Gift Aid donations and reclaim tax thereon. <  > please tick here.
I confirm that I am a UK tax payer

Subscriptions are due on 1 January each year as follows:-

Gift Aid Declaration      A Gift Aid Declaration enables us as a charity (registered no. 202014) to recover from the Inland Revenue the income tax on your subscription. If you pay some tax at the basic rate it will not cost you a penny. At a basic rate of 22% we can reclaim £2.80 on each £10 subscription. So please tick the Gift Aid box above and complete the form below. This will bring in useful extra income.

Please send your completed form with subscription or Banker's Order (below) to the Honorary Membership Secretary:   Mrs. S. Swart, The Winnats, Kestrel Close, Cheltenham, GL53 0LQ

Applicants will normally be elected to membership at the quarterly Council meeting following receipt of their application

Please treat all donations (including membership subscription) I may make to the Charity on or after the date of this Declaration as Gift Aid donations and reclaim tax thereon.

I confirm I am a UK tax payer.

Signed: …………………………………….date: …………………………………..

Full name in capitals: …………………………………………………………………

Address: ……………………………………………………………………………….

………………………………………………Post Code:……………………

To the Manager,..............................................................................Bank Limited

Address..............................................................................................................................

...................................................................... Sort Code ..................................................

Please pay on receipt of this instruction and on 1 January in each subsequent year until further notice, an annual subscription of £..................(please insert the amount of your subscription) to the account of the Bristol and Gloucestershire Archaeological Society, Barclays Bank plc., PO Box 207, 14/16 Queens Square, Bristol, BS99 7AJ, Bank Code 20-13-42, Account No. 00196460. This instruction cancels any previous instruction concerning the Society.

Signature ...................................................................................................................….

Name (capitals) ..........................................................................................................…

Account No. ........................................... Date .........................................…………….

Please complete the whole form and sent it to: The Membership Secretary, Mrs. S. Swart, The Winnats, Kestrel Close, Cheltenham, GL53 0LQ