Application for membership of the Museum
of Power
Title
. Initials
.. Surname
Address
.. Postcode
E-Mail
address
Telephone
No:
...
Membership is for one calendar
year, renewable from 1st January.
If you join after the end of July only ½ the fee is payable, after the
end of September no fee is payable for the remainder of that year. If membership renewal fee is not received
within one month of our reminder letter, then membership shall cease. A member is entitled to one vote at an AGM.
Your membership card should be produced on request at the AGM
Category of
Membership Fee paid Office Use only
Family £21.00 (Covers applicant/spouse/family) £
.. Date Accepted
.
Single £17.00 (Applicant Only) £
..
Membership
No:
..
Senior £15.00 (Applicant only, of retirement age) £ .. Secs Initials .........
Junior £13.00 (Applicant under the age of 18) £ ..
Please make your cheque payable to The Museum of
Power and return with this form to The membership Secretary at The Museum of
Power, Hatfield Road, Langford, Maldon, Essex. CM9 6QA
___________________________________________________________________________________________
The museum is a Registered Charity, as such, we can claim 25 pence back on each pound paid of your subscription or donation from the Inland Revenue. However, you must be currently paying income tax and resident in the United Kingdom.
Gift Aid Declaration
for the Museum of Power Charity Number 1087459
I would like the charity to
treat all subscriptions and donations that I have made since 6th
April 2005 and all subscriptions and donations that I make from the date of
this declaration, until I notify you otherwise, as GiftAid donations
Name .. Signed Date Membership No: .
_____________________________________________________________________________
It would save us some
administration costs if you could pay by Standing Order.: Complete this instruction to your bank or
Building Society
Detach
here
.detach here
Standing Order to Santander Bank, Bootle, Merseyside L30 4 GB
The Manager of
..Branch
Name & Address
..
Post Code
.
Please pay Santander bank
sort code 09-01-53 for the credit of the MUSEUM of POWER Account
No: 77743283 Reference
(your membership number) the
sum of £
.. Amount in words
..
Commencing 1st January
2012. The amount of the first payment
£
.. and thereafter every 1st January until further notice,
and debit my account accordingly.
Name(s) of Account
Holders
. Bank sort
code
. Account No:
NAME(S)
Address
..
.Post
Code
..
After completion, please detach and forward this
instruction to the branch which looks after your Account