MEMBERSHIP FORM

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					                                                               FRIENDS OF COURT BARN MUSEUM

          MEMBERSHIP FORM                                                          PAYMENT                                             STANDING ORDER


I/We wish to join the Friends of Court Barn                I enclose my payment of £___________ by                              To pay annually by Standing Order please
as (please tick as appropriate)                                                                                                 complete this section IN BLOCK
                                                                      cash / cheque made payable to The
         Single adult            £15                                                                                            CAPITALS. Please send the completed
                                                                      Friends of Court Barn Museum .
          Joint (at same address)           £20                       Credit Card payment (in museum only)                      form to the Membership Secretary at the
                                                                                                                                address shown at the bottom left of this form.
          or/and make a donation             £                        Renewal Standing Order enclosed
                                                                                                                                Bank name:
Annual renewal date is April 1st each year.                & completed Gift Aid declaration (if
                                                           applicable)                                                          Address of your Bank (including postcode):
If membership is a gift, please give recipients name and
address below, and date gift to arrive ____/____/____
                                                                      GIFT AID DECLARATION
PLEASE USE BLOCK CAPITALS
                                                           I want the Friends of Court Barn Museum to
Name:       ___________________________                    treat my         total donation (min £15) of
Second Name _______________________                        £............... (including my subscription to
                                                           The Friends ), and all donations I make                              Bank sort code: _____-_____-_________
( if joint membership )
Address:                                                   from the date of this declaration until I notify
                                                                                                                                Acct Name: ________________________
___________________________________                        otherwise, as Gift Aid donations.
___________________________________                                                                                             Acct Number: ______________________
___________________________________                        Signature                                  Date __/__/___            Please pay to The Friends of Court Barn
                                                           Notes:                                                               Museum, Acct No. 31555243, at HSBC
___________________________________                                                                                             Bank (Evesham branch) plc, 32 Bridge St,
                                                              Please notify The Friends if you change your name or
Telephone: _________________________                           address while the declaration is still in force                  Evesham, WR11 4RU (sort code 40-20-27).
                                                              You must pay an amount of income or capital gains tax
Email:      ___________________________                        equal to the tax we reclaim on your donations (25p for           On the 1st day of April 2012.
                                                               every £ that you give)                                           The sum of £15/20 (fifteen/twenty pounds
Please complete this form and send to:
                                                              Please notify The Friends if you no longer pay tax.              only)(delete as appropriate), being my
The Membership Secretary
                                                               If you pay tax at the higher rate you can claim further         subscription, and the same sum on the same
Friends of Court Barn Museum
                                                                tax relief in your Self Assessment tax return.                  date annually until further notice.
Court Barn Museum
                                                            The Friends is considered a charitable organisation and is exempt
Church Street                                              from income tax.                                                     Signature
Chipping Campden                                           Guild of Handicraft Trust, Registered Charity No: 1007696
                                                                                                                                _____________________________
GL55 6JE
                                                                                                                                Date ____/______/______

				
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posted:10/4/2012
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