Membership Application

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First Name*

Last Name*

Address 1*

Address 2

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Telephone*

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Product Name

Membership Options*

Annual Membership

Public Liability Insurance (delete if not wanted)

Donation

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Payment Information

Pay by BACS
Account Name: Lune Valley Beekeepers
Sort Code: 77-26-17
Account No: 29993268

Send a cheque payable to Lune Valley Beekeepers, High Tarn, Aughton, Lancaster, LA2 8LU

Consent*

I consent to the holding of my membership records on computer and consent to disclosure to other members of the Charity and BeeBase.

I do not consent to the holding of my membership records on computer and do not consent to disclosure to other members of the Charity and BeeBase.

Signature*

Date*

Gift Aid declaration (for tax payers only)– past, present & future donations

Please treat my subscription as a Gift Aid donation. I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for the current tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities and Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for the current tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1 that I have given.

Lune Valley Community Beekeepers – HMRC Charities Reference XT22947

Signature*

Date*

Membership Application

Payment Information

Gift Aid declaration (for tax payers only)– past, present & future donations

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