Individual and Joint membership form Your Details Title Please enter your title. First name(s) Please enter your first name. Surname Please enter your surname. Email address Please enter your email address Address Please enter your address. Postcode Please enter your postcode. Telephone number Please enter your telephone number If this subscription is a gift, please fill out the recipient's details below Recipient details Recipient title, first name and surname Please enter the full name of the recipient. Recipient address including postcode Please enter the address and postcode of the recipient. If you wish to Gift Aid your membership payment, please read the following declaration and confirm your choice by checking the box Gift Aid Declaration I want to Gift aid my membership payment and / or donations I make now, in the future or have made in the last four years to the Yorkshire Dales Society - the charity of the Friends of the Dales. I am a UK taxpayer and understand that if I pay less Income Tax and / or Capital Gaints Tax than the amount of the Gift Aid claimed on all my donations in that tax year, it is my responsibility to pay the difference. Please notify Friends of the Dales if you want to cancel this declaration, or change your name or home address, or 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 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. I confirm I have read this declaration and agree Please confirm you agree to the Gift Aid declaration. Membership Membership type NewRenewal Membership Category Select your membership category...Individual (£30)Joint (two Friends at the same address) £40Life Membership - Individual (£400)Life Membership - Joint (£550)Life Membership (over 60) Individual (£300)Life Membership (over 60) Joint (£450) Please select a Membership Category. Title, first name and surname of joint member Please enter a name for the joint member. Payment Payment method Select your preferred payment method...PayPalBank TransferDirect DebitChequeTelephone Please select a Payment method. Contact Preferences Check this box if you want us to send you information on Life membership Check this box if you want us to send you information on Legacies Check this box if you'd like to receive our free monthly e-newsletter How did you hear about Friends of the Dales?
