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PETS CLUB MEMBERSHIP APPLICATION FORM

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					                            PETS CLUB MEMBERSHIP APPLICATION FORM
                                CLASS                                                                                            FEES
                                Single                                                                                           £5 for life
                                Family (2 or more pets at the same address)                                                      £7.50 for life
PET OWNER’S NAME ..............................................................................................................
ADDRESS .....................................................................................................................................
........................................................................................................................................................
P/Code ...........…….............                  Phone .........................................................................................
E-mail ...........................................................................................................................................
PET’S NAME(s) ..........................................................................................................................
TYPE OF PET (eg Dog/Cat etc) ........................................................ ................. Male/female*
(OR COLLECTIVE FAMILY TITLE) ....................................................................................
I enclose the membership fee of £……….. which represents *single/family class of Pets Club membership.
I also make a donation to the Trust of £..................
Total remittance enclosed              £..................
Please enroll the above pet/pets * into the Lichfield & Hatherton Pets Club
(* delete as appropriate)

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

                  Please make cheques payable to:- Lichfield & Hatherton Canals Restoration Trust Ltd
         A photograph for our website would be appreciated. See www.lhcrt.org.uk/gallery5.htm

Send to:              Sue Williams, Lichfield & Hatherton Canals Restoration Trust Ltd
                      Norfolk House, 29 Hall Lane, Hammerwich, Burntwood, Staffordshire WS7 0JP
                      Photographs can be emailed to info@lhcrt.org.uk
  For Trust use:
  Date Rec’d:                                                                                Pets Club Membership No.

                                               If you are a taxpayer, please complete the Gift Aid Form below
                                                    to assist us with recovery of tax from Inland Revenue .
                                   Use Gift Aid and you can make your subscription worth more. For every £1 you give
                                   us we get an extra 28p from the Inland Revenue. So just sign here. It’s that simple.

                                        GIFT AID DECLARATION for tax recovery
I (full name in capitals) ………………………………………………………….….. of (address)
........………….......................................................................................…………………………..
.......................................……………...………….........……………....Postcode ...........................
declare that all donations I make to the Lichfield and Hatherton Canals Restoration Trust Limited on or
after the date of this declaration are to be treated as Gift Aid donations on which I must pay an amount
of income tax or capital gains tax equal to the amount of tax you reclaim on my donations.
Signed and delivered,                    Day ...…….......... Month ...........….....Year ...…….......

Signature ...................................................................................................
N.B. to be signed only by a Taxpayer

				
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