Membership Renewal 2017/2018 (Must fill= *)




Gift Aid Declaration

I want to Gift Aid my membership and any donations I make in the future or have made in the past 4 years to:

The Bromyard & District Local History Society

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.

Please let the the Membership Secretary know if you:

  • want to cancel this declaration
  • 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 HM Revenue and Customs to adjust your tax code.

Payment Instructions:

  1. Preferred:
    By Internet Banking or Bank Transfer to:
    Bromyard & District Local History Society
    Sort Code: 30-94-99 Account Number: 01222219
    Reference: Membership 2017
  2. By PayPal, credit or debit card using the form following submission of this application.
  3. By Cheque payable to Bromyard & District Local History Society
  4. Or, (if you must) in cash.

Membership Secretary

Sue Cooper, Bromyard & District Local History Society, 5 Sherford Street, Bromyard, Herefordshire. HR7 4DL