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The Richmond Society Membership Application

Registered Charity 1169079

To apply for membership please print this page, complete the form and send it to:
Richmond Society, 8 Mount Ararat Rd, Richmond, TW10 6PA.
membership@richmondsociety.org.uk

The Society’s membership year runs from 1st October each year.

Ordinary Annual Membership

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£5

Individual

 

Checkbox

£8

Household (1-2 adults + children under 18)

Life Membership

 Age under 60

Checkbox

£120

Single

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£190 Double

 

 Age 60 & over

Checkbox

£75

Single

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£120 Double

Corporate Annual Membership

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£30

Companies

 

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£13

Non profit making organisations

I include a contribution to the Society’s work:

£

………………

TOTAL ENCLOSED cash / cheque

£

………………

 Name and Address details

Name(s)

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

Address

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

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

Post Code

………………………………….

Telephone

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

Email 1

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

Email 2 (if applicable)

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

Taxpayers should also complete the GIFT AID declaration below

I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for the current tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities and Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for the current tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1 that I have given. I will contact you if I change my name or home address and if I want to cancel this Gift Aid declaration either because I no longer pay sufficient income tax or otherwise.

Signed
……………………………………………………………………..

Date
………………………………….

To pay by Bank STANDING ORDER
please also complete the section below

or for DIRECT DEBIT contact the Membership Secretary
at the address above.

To Bank Name

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

Bank Address

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

Sort Code

……….  –  ……….  –  ……….

Please pay to Lloyds Bank plc, The Quadrant, Richmond, Surrey (Sort Code 30-84-57) for the account of THE RICHMOND SOCIETY Account No 34877468 on receipt hereof and hereafter annually on 1st October the sum of £ ………. from my Account.

Name

  ……………………………………………………………

Account Number  ………………………………….

Signed

  ……………………………………………………………

Dated  ………………………………….

The Richmond Society is Registered Charity No 1169079

Membership enquiries to: membership@richmondsociety.org.uk
General enquiries to: secretary@richmondsociety.org.uk