Membership

MEMBERSHIP FORM
Membership runs from Jan 1st to Dec 31st each year and is renewable on 1st September. Please print this form and send it with your cheque or standing order (see below) to Alan Petts, 5 Bigstone Grove, Tutshill, Chepstow NP16 7EN. Alternatively the form, together with the payment by cash or cheque (or standing order), can be given to the Society at one of our meetings. The sections in bold will need to be filled in.

Please circle which membership of the Chepstow Archaeological Society you require:-

Ordinary Member £12.00 Student/Retired £6.00
Retired Family £12.00 Family Member £15.00

Cheques should be made payable to Chepstow Archaeological Society. I am also content for my records to be held on computer for CAS use only.

Name _______________________________________________
Address _______________________________________________
Post code _________________ Tel___________________________
Email _______________________________________________

GIFT AID DECLARATION
Please treat as Gift Aid donations all qualifying gifts of money (including membership subscriptions) to Chepstow Archaeological Society made today and in future. I confirm that I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6th April to 5th April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs to which I donate will reclaim on my gifts for that tax year. I understand the charity will reclaim 25p of tax on every £1 that I give. I will notify Chepstow Archaeological Society if I want to cancel this declaration or no longer pay sufficient tax on my income and/or capital gains.

Signature……………………………………………………………….
Date……………………………………………………………………….

In the case of family membership, the family member making this declaration must be the person making the donation (membership subscription) and must personally satisfy the tax requirement.

Standing Order Form (Optional)
Bank or Building Society details:
Bank Name________________________________________________
Address____________________________________________________
____________________________________________________________
__________________________Post Code________________________
Bank sort code _____ – _____ – _____
Account number ________________________
Account name ________________________

Please pay Lloyds Bank, 7 Manor Way, Chepstow, Monmouthshire, NP16 5HZ, to the credit of Chepstow Archaeological Society (a/c 00736255 sort code 30-91-89) the sum of (please circle below as appropriate):
£6.00 £12.00 £15.00
Please pay the first year’s payment immediately and thereafter on 1st September every year, starting next year*…………..,……. until cancelled by me.
Signed_______________________________________________
Date _______________________________________________
*Please insert the year after the above signing date

Registered Charity no 1096541