Please complete the form.  Print it out and send it with your subscription to the Secretary.

Items marked * are required.

 

   Membership Subscription:

 

Please make your cheque for the above amount payable to:

Northamptonshire Record Society

Gift Aid Declaration

I would like the tax to be reclaimed on any eligible membership subscriptions or donations that I make to the Northamptonshire Record Society until further notice. I confirm that I pay an amount of UK income or capital gains tax at least equal to the tax the Society will reclaim, and I will notify you if my tax status changes.

 

Signature: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      Date: . . . . . . . . . . . . . . . . . . .

 

Standing Order Mandate

    Account Number: *

Please pay to the account of Northamptomshire Record Society,
Nat. West Bank Account No. 05620562, Sort Code 56-00-60

 (in words)

on the *  day of   20   
and then annually on 1st January each year.

 

Signature: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      Date: . . . . . . . . . . . . . . . . . . .

 

Send the completed form, signed in two places as appropriate, together with your remittance to:

The Secretary,
Northamptonshire Record Society, Wootton Hall Park, Northampton NN4 8BQ.