Addlestone Community Association

Addlestone Community Association
Membership application

Please print this document, complete and return to Membership Secretary, Community Centre, Garfield Road, Addlestone, Surrey, KT15 2NJ
Name: ..................................................................................................
Address: ..................................................................................................
  ..................................................................................................
  ...........................................................Post Code.........................
Phone no: ...................................................................
Annual Membership:
 ..................................................................................................
(£3.00 individual / £5.00 couples, same address)
Life Membership: ..................................................................................................
(£30.00 individual / £50.00 couples, same address)
Joining Fee: £1.50 (also a late renewal fee if annual membership is renewed after May 31st.)
Total Sum enclosed: ..................................................................................................
(please make payable to Addlestone Community Association)

IF YOU PAY INCOME TAX PLEASE READ THIS
Use Gift aid and you can make your donation worth more. For every pound you give us we get an extra 28p from the Inland Revenue. So just tick here. It’s that simple. ...

Declaration to the ADDLESTONE COMMUNITY ASSOCIATION
Registered Charity No. 304962

Please complete in block capitals

Title........................... Forename .......................................................................

Surname ...........................................................................................................

Address ............................................................................................................

........................................................................... Post Code .............................

I want the charity to treat as Gift Aid Donations:

a) the enclosed donation/subscription of £..........................
b) all donations/subscriptions I have made since 6th April 2000, and all donations I make from the date of this declaration


Signature ........................................................ Date .................................

NOTES
For Joint Membership each Tax payer must complete one of the above declarations.
You must pay an amount of income tax and/or capital gains tax at least equal to the tax that the charity reclaims on your donation in the tax year (currently 28p for each £1 you give).
You may cancel this declaration at any time by notifying the charity.
If in the future your circumstances change and you no longer pay tax on your income and capital gains equal to the tax the charity reclaims, you can cancel your declaration.
If you pay tax at the higher rate you can claim further tax relief in your Self-Assessment tax return.
If you are unsure whether your donations qualify for Gift Aid tax relief, ask the charity.

Charity Registration number 304962