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Sutton Coldfield Civic Society
Membership Application Form

Please print this form and complete it in ink.

Then post it to:

Mrs B. White
77 Elizabeth Road
Sutton Coldfield
B73 5AP

Cheques should be made payable to:

"Sutton Coldfield Civic Society"

Please do not send cash.


IMPORTANT INFORMATION:

Because we are a registered charity, the Civic Society can claim back some money from the Inland Revenue in respect of your subscription.

This does not cost you anything extra and if you join this "Gift Aid" scheme, you can change your mind at any time.

This scheme is entirely voluntary. If you do not wish to join the scheme, or if you are not an Income Tax payer, please ignore the Gift Aid form.

Thank you.

PLEASE FIND ENCLOSED MY/OUR CHEQUE FOR £............... AS THE SUBSCRIPTION FOR MEMBERSHIP OF THE SUTTON COLDFIELD CIVIC SOCIETY FOR THE CURRENT YEAR.

SUBSCRIPTION RATES ARE: INDIVIDUAL £9.00 OR HOUSEHOLD AT ONE ADDRESS £14.00

From: Mr/Mrs/Ms

Address:

Post Code:

Tel No:

E-mail Address:

GIFT AID DECLARATION

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SUTTON COLDFIELD CIVIC SOCIETY
REGISTERED WITH THE CIVIC TRUST

I am a taxpayer. I want the charity to treat all donations as Gift Aid from the date of this declaration until I notify you otherwise. (Where there is a joint membership, only one that is a taxpayer need sign)

Title:

Forename(s):

Surname:

Address:

Post Code:

Signed:

Date:

Notes:
1. You must pay an amount of income tax and/or capital gains tax at least equal to the tax that the charity reclaims on your subscription in the tax year.
2. You can cancel this declaration at any time by notifying the charity.