Sutton Coldfield Civic Society

Membership Application Form

Please print this form and complete it in ink. Then send it to :-  Mrs.C.Stubbs, 4 Brentnall Drive, Sutton Coldfield B75 5BB
Cheques should be made payable to " Sutton Coldfield Civic Society".  Please do not send cash.

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 £12.00 OR HOUSEHOLD AT ONE ADDRESS £17.00.

From Mr/Mrs/ Ms

Address

Post Code

Telephone number
E-mail address
..................................................................................................................................................................................................

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 and if you join this Gift Aid scheme, you can change your mind at any time. The 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.

If you completed the Gift Aid Declaration Form last year and wish the Society to claim for this year you need not complete the form again.

Please tick to confirm previously completed Gift Aid Declaration


                                                                     GIFT AID DECLARATION
                                                           SUTTON COLDFIELD CIVIC SOCIETY

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 (I understand that if there is a joint membership, both members must complete and sign the Gift Aid Declaration form).

Title                    Forename                                           Surname


Address

Signed                                                                                        Date                                         2014

Title                    Forename                                          Surname

Address

Signed                                                                                       Date                                          2014     

 

 NOTE;
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 Society