LANGTON MATRAVERS LOCAL HISTORY AND PRESERVATION SOCIETY

APPLICATION FORM

I/We would like to join the Langton Matravers Local History and Preservation Society

    1.   Title.........Forename...................................Surname........................................................

    2.  Title..........Forename...............................    Surname....................................................

      Address....................................................            e-mail..............................................

                .....................................................              Telephone .....................................

                .....................................................   

                .......................................................             Postcode............................. 

      Individual Membership (£5.00) ........    Family/Joint (£7.50)........     Member(s) for Life£100........

PLEASE SEND THIS FORM WITH A CHEQUE PAYABLE TO

LANGTON MATRAVERS LH AND PS

To:-  David Selman, Priest’s Barn, Belle Vue Farm, Swanage BH19 2SQ

IF YOU PAY INCOME TAX THE SOCIETY CAN RECLAIM THE TAX YOU PAY ON THE AMOUNT OF YOUR SUBSCRIPTION IF YOU COMPLETE THE FOLLOWING GIFT AID DECLARATION    

LANGTON MATRAVERS LOCAL HISTORY AND PRESERVATION SOCIETY

Registered Charity No 272407

GIFT AID DECLARATION

Name of taxpayer   .......................................................................................................................

Address (please complete in full....................................................................................................

....................................................................................................................Postcode.........................

I would like all my subscriptions and any donations I make after 1 January 2016 and until further notice to the Langton Matravers Local History and Preservation Society to be GIFT AID donations

Signed..............................................................................................   

 Date.................................

1 You must be paying an amount of Income Tax and/or Capital Gains Tax at least equal to the tax we reclaim each year on your subscription and any donations you make to the Society

2 You may cancel this declaration at any time by notifying the Treasurer of the Society

3 Please notify the Membership Secretary or the Treasurer of any change of address

4 If you pay tax at a higher rate you can claim further tax relief in your Self Assessment Tax Return

5 If yours is a Joint or Family Membership the taxpayer must be named and sign this Declaration

PLEASE RETURN THIS GIFT AID DECLARATION TO THE TREASURER OF THE SOCIETY

David Selman, Priest’s Barn, Belle Vue Farm, Swanage BH19 2SQ