The Guildford Society

MEMBERSHIP APPLICATION FORM

I/We wish to join The Guildford Society as:          (please tick as appropriate)

            Individual Member......£10      Life Membership...........          Individual £100

            Joint Members............£18      Life Membership...........         Joint         £180

Name  ……………………………………………………………………………………….....

Address…………………………………………………………..…………………..…………

……………………………………………..…    Post Code    ….………………………..

Email   ………………………………………… Telephone    ….……………..……………..

Please indicate how you might like to contribute to the work of The Society:

---------------------------------------------------------------------------------------------------------------

Gift Aid Declaration

I wish, and agree, that all donations or subscription payments be treated as a Gift Aid

donation until I notify you otherwise, as I pay an amount of Income Tax or Capital Gains Tax

equal to the tax deducted from the donation.

Name  (in capitals)………………………………………………………………..…...….…

Address …………………………………………………………………………….………..  

Signature ……………………………………..          Date …………………………………

__________________________________________________________________________

Bankers’ Order (This form of payment is preferred to a cheque)

My Bank’s Name……………………………………… …………………………….…......

Bank’s Full Address……………………………………………………………….………..

…………………………………………………          Post Code    ….……………………..

Please pay to:  Santander     sort code    09-01-52         account number 39768701

For the credit of The Guildford Society the sum of 

£ …………      (in words……………………………………………..) and thereafter annually

on the day shown below and debit my account accordingly, until cancelled by me in writing. 

Please quote reference number (to be provided by The Society)  ……..………………..…….

Name of Account to be debited    …….……………………………………………….……....

Sort Code     ..........-..............-............       Account Number.......................................................

Signature ……………………………………..     Date ………………………………………

___________________________________________________________________________

Please return this Form with cheque or completed Bankers’ Order to

John Shorto, Membership Secretary, The Guildford Society,

To print this form, right click on this web page and select print from the drop down menu.