Membership Application Form (UK)

          

 

Please click here if you live in the USA OR

click here if you want to pay by standing order

 

 

TO JOIN if you live in the UK, please complete the form below, and send to the treasurer:  

Gaby Weiner, 27 East Street, Lewes, East Sussex BN7 2LJ, UK

 

 

 

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To Gaby Weiner, 27 East Street, Lewes, East Sussex  BN7 2LJ, UK

 

 

WE/I/this Institution would like to enrol in The Martineau Society

 

(capitals please):   Name      ........................   Address   ........................                 .........................                 .........................     Postcode ..........................   Email       ..................

Annual subscription rates: Institution  £45 Individual   £20 Concessionary (student/senior) £10.00 Life member (individual) £200

 

 

Please find enclosed cheque, payable ‘The Martineau Society’, for  £……...............

 

I/We have no objection to my name/our names and addresses, as given on this form, being added to a database

which will be confidential to the society.

 

 

 

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

 

 

GIFT AID DECLARATION: The following section should be signed ONLY if you are a UK tax-payer and agree to its terms; viz.

 

I am a UK tax-payer residing at the address given above and would like my subscription and/or other donations

made to the Martineau Society in my name to be regarded as Gift Aid for the purpose of enabling the Society to

reclaim income tax. I further declare that I pay sufficient income tax to meet the sum to be reclaimed by the Society

against my name from HM Revenue and Customs.

 

 

 

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