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
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