COWC Membership Form

Carlisle One Word Centre

Membership Form
Thank you for becoming a member of COWC Please complete your details below.
Name

TitleFirst Name / initialsSurname
Full Home Address
Postcode
Tel
Email
example@example.com
Consent to be informed by email of news, events, and activities of COWC

YesNo
Receiving regular donations greatly assists COWC in managing its finances. If you are able to give a fixed amount each month (minimum £5) or the standard donation of: £7 (concessions) / £15 (individuals) / £30 (organisations) each year, please complete the form below.
Select payment amount as appropriate

Fixed amount £5Yearly amount £7Yearly amount £15Yearly amount £30Other
Bank Name
Bank Address
Sort Code
Account Number
Gift Aid

Gift Aid Declaration - Boost your donation by 25p of Gift Aid for every £1 you donate Gift Aid is reclaimed by the charity from the tax you pay for the current tax year.I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.
Alternatively, Please arrange a one off payment for the applicable amount; Cash / Cheque / Bank transfer using Sort Code: 16 52 21 Account No: 54087877

Please make cheques payable to: Carlisle One World Centre and send to: COWC, FAO The Treasurer, 2 Lowthians Lane, Carlisle CA3 8JR
Signed (Type name)
Dated

MonthDayYear
Date
Please notify COWC if you: Want to cancel this declaration; Want to stop receiving emails about COWC's news and activities; Change your name or home address; No longer pay sufficient tax on your income and/or capital gains. If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HMRC to adjust your tax code.

contact@cowc.org.uk
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Carlisle One Word Centre