The Richmond Society Membership Application
Registered Charity 285805
To apply for membership please print this page,
complete the form
and send it to the Membership Secretary
Karineh Grigorian, 7 Hamilton Court, Hamilton Road, London W5 2EJ.
Ordinary Annual Membership |
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£5 |
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Individual |
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£8 |
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Household (1-2 adults + children under 18) |
Life Membership |
Age under 60 |
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£120 |
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Single |
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£190 Double |
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Age 60 & over |
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£75 |
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Single |
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£120 Double |
Corporate Annual Membership |
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£30 |
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Companies |
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£13 |
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Non profit making organisations |
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I also enclose a contribution to the Society's Tree Planting Fund |
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TOTAL ENCLOSED cash / cheque |
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£ |
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Name(s) |
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Address |
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Post Code |
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Telephone |
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Email |
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Taxpayers should also complete
the GIFT AID declaration below
I confirm that I wish my subscription
and any donations to be treated as Gift Aid payments until further notice.
I confirm that I am a taxpayer paying at least the amount of income
or capital gains tax the Richmond Society is able to reclaim on my payments
(£2.80 per £10.00 of donation at current rates of tax).
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Signed
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Date
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To pay by Bank STANDING ORDER
please also complete the section below
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To Bank Name |
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Bank Address |
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Sort Code |
.......... - .......... - ..........
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Please pay to Lloyds Bank plc, The Quadrant, Richmond, Surrey (Sort Code 30-97-06)
for the account of THE RICHMOND SOCIETY Account No 0221758 on receipt hereof
and hereafter annually on 1st October the sum of £ .......... from my Account.
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Name |
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Account Number ........................................ |
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Signed |
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Dated ........................................ |
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The Richmond Society is Registered Charity No 285805
Enquiries to: secretary@richmondsociety.co.uk
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