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The Richmond Society Membership Application

Registered Charity 285805

To apply for membership please print this page, complete the form
and send it to:
Membership Secretary, 6 Queensberry House, Friars Lane, Richmond TW9 1NT.
membership@richmondsociety.org.uk
 
 

Ordinary Annual Membership

   

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£5

 

Individual

 

   

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£8

 

Household (1-2 adults + children under 18)

Life Membership

 Age under 60

   

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£120

 

Single

   

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£190 Double

 

 Age 60 & over

   

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£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(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 30-97-06) for the account of THE RICHMOND SOCIETY Account No 00221758 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 285805
Enquiries to: secretary@richmondsociety.co.uk