Rotherham Family History Society
Registered Charity No 1113670
|
| |
Membership Application/Renewal Form |
Please
Complete in BLOCK CAPITALS |
|
Former membership number ................................ (if applicable) |
| |
| Title (Mr / Mrs / Miss / Ms / Dr / etc)................................................................ |
| |
| Surname ........................................................................................................... |
| |
| Forename(s) ..................................................................................................... |
| |
| Address.............................................................................................................. |
| ............................................................................................................................. |
| ............................................................................................................................. |
| |
| Post Code ......................................................................................................... |
| |
| Country ............................................................................................................... |
| |
| Phone No. .......................................................................................................... |
| |
| Email Address................................................................................................... |

GIFT AID DECLARATION
I am a UK taxpayer and I wish Rotherham FHS to
treat as Gift Aid Donations all
donations (inc membership subscriptions), I have paid since 6th April
2000 and all donations (inc membership subscriptions) that I make
from the date of this declaration until I notify you
otherwise. I understand that I must pay income tax or capital gains
tax at least equal to the
tax reclaimed by the Society.
Signed:..................................................... Date:................................................ |
I enclose the Annual Membership subscription of
|
Individual £11.00
: Family Membership £13.00 : Overseas £14.00: |
Please make cheques payable to : Rotherham F. H. S |
Signed
..................................................... Date................................................. |
Please return completed form to :
Mrs Margaret Ensor
20 Rose Hill Avenue, Rawmarsh, Rotherham, South Yorkshire. S62 5NA
(Please ensure that you use the correct address)
|