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Swindon & Cricklade Railway
Life Membership Application
If you already have another class of membership, (eg, an Adult Membership)
please fill in the appropriate section
below
NAME
ADDRESS
POSTCODE
If you are an existing member, tick here [ ]
If you know
your membership number, please add it here
Life Membership fees are either (a) a single payment of £175.00 or (b) three consecutive annual payments of £60.00, the first payment being returned with this form.
Either (cross out the one that doesn't apply)
I enclose my cheque / PO for £175.00 (Life Membership paid in full).
Or
I enclose my cheque / PO for £60.00 as the first of three annual payments.
Life membership does not take effect until all payments are made. You will be sent special forms for subsequent instalments and receipts for all 3 payments. Should you fail to make subsequent payments your membership will expire after 5 years!
SIGNATURE OF APPLICANT
Your details will be held in a database. This is to enable us to administer your membership. We will not pass on or reveal your details to any other organisation.
GIFT AID. If you are a UK taxpayer, as a
Registered Charity we can collect an additional contribution from the
Inland Revenue under the Gift Aid scheme. Please sign you name below if
this is the case.
_________________________________ (signature) I
confirm that I am a UK Taxpayer and that the above payment, and any other
payments made to the Swindon & Cricklade Railway (e.g. membership
renewals), are eligible for the Gift Aid scheme.
Please return this form with your remittance to The Membership
Secretary, Swindon & Cricklade Railway, 31 Rose Street, Swindon SN2
2HH. Allow 28 days for processing. |