MEMBERSHIP APPLICATION FORM

Annual subscription rate per household (please tick): UK £25 ___; overseas in sterling £30 ___. Payment can be made by standing order (preferred), BACS or cheque. We also accept payment by PayPal but please note that, to cover the cost of PayPal fees, the cost of membership using this method (please tick) is £27 per year (UK) ___ and £35 per year (overseas) ___.

I/we wish to join The Caughley Society.

NAME(S): ..........................................................................................................................................

ADDRESS: .........................................................................................................................................

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.......................................................................................... POSTCODE/ZIPCODE: ...............................

TEL: .............................................. EMAIL: ......................................................................................


___ Please tick here to show that you agree that The Caughley Society may use your data in line with its Privacy Policy in order to deliver its services to you.

• If you wish to pay by standing order (preferred), please tick here ___ and we will send you the necessary details.
• If you wish to pay by BACS, please tick here ___ and we will send you the necessary details.
• If you wish to pay by cheque, please make it out to 'The Caughley Society'.
• If you wish to pay by PayPal, please use the relevant PayPal button at the bottom of this page.

If you are eligible, we would be most grateful if, in addition, you will complete the Gift Aid declaration below. This will allow us to claim back basic rate tax at no cost to yourself.

Please treat this and all future subscriptions and donations as being made under Gift Aid. I confirm that I have paid, or will pay, an amount of income tax and/or capital gains tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or community amateur sports clubs that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and council tax do not qualify. I understand that The Caughley Society will reclaim 25p of tax on every £1.00 that I give. I will notify the Society if I wish to cancel this declaration, change my name or home address, or no longer pay sufficient tax on my income and/or capital gains.


SIGNATURE: ................................................................................... DATE: .........................................