New Member Form

1

MEMBERSHIP TYPE* This field is required.

Single

Joint

Concession

3

NAME* This field is required.

First Name

Last Name

4

EMAIL* This field is required.

example@example.com

5

LABELS* This field is required.This will allow us to label members into different groups for communication purposes. Most members will be Friends

Friends

Committee Member

Butser

6

ADDRESS* This field is required.

House Name / Number and Street Address

Street Address Line 2

Town / City

County

Post Code

Country

7

HOME PHONE NUMBER

8

MOBILE PHONE NUMBER

9

Unique ID

10

Are you happy for us to process your data?* This field is required.Data collected is used to process your application and administer your membership.

Yes

No

11

Would you like to gift aid your subscription?* This field is required.This allows you to boost your donation, and any further donations, by 25p for every £1 you donate. Gift Aid is reclaimed by the charity from the tax you pay for the current tax year. By selecting 'Yes' you declare that you are a UK taxpayer and understand that if you pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all donations in the tax year, it is your responsibility to pay any difference.

Yes

No

13

JOINT MEMBERS ONLY - NAMEPlease add the name of the joint member

First Name

Last Name

14

JOINT MEMBER ONLY - EMAILIf a second email address is provided for joint memberships, please enter that here

example@example.com

15

JOINT MEMBERS ONLY - ALTERNATE ADDRESSIf the joint member is at a different address, please enter that here

Street Address

Street Address Line 2

City

County

Postcode

Country

16

JOINT MEMBERS ONLY - ALTERNATE HOME PHONE NUMBERIf the joint member is at a different address, please enter the home phone number here

17

JOINT MEMBERS ONLY - MOBILE PHONE NUMBERIf a second mobile number is provided for joint memberships, please enter that here.

18

NOTESPlease use this field for any additional information you think may be helpful for us to know.

19

Choose your subscriptionWe offer single, joint and concession memberships. Single memberships are for one adult, joint memberships are for two adults and concessions are available for students and those in receipt of benefits or a state pension.

Concession Membership
£20.00 for each year
SUBSCRIBE
Joint Membership
£40.00 for each year
SUBSCRIBE
Single Membership
£25.00 for each year
SUBSCRIBE

20

2022 Amount Due