HALIFAX ANTIQUARIAN SOCIETY

Membership Form

Title:
Forename:
Surname:
Address:
Town:
Post Code:
Country:
Telephone:
email:

Check this box if you do NOT want to receive emails from us (we will not pass your details on to any other organisation)

Name(s) of Associate(s):
Members @ £22 (£27 outside UK:
Associates @ £5:
Corporate Members @ £22 (£27 outside UK:
Total amount payable: £

My / Our main interests are (tick all that apply)

Family History

Local Buildings

Industrial History

Transport

Education

Religion

Archaeology

Research

Visits

Lectures

Day Schools

Pre 1700

Local Government

Post 1700

Specific Interests:

www.halifaxhistory.org.uk

Registered Charity No. 1050252

If you are a UK tax payer please complete this gift aid declaration form as this will enable us to claim extra money for every pound paid.

Please print out and send with your payment to:

Membership Secretary

Halifax Antiquarian Society, 115 Siddal Lane, Halifax, HX3 9JS, UK

GIFT AID DECLARATION

I want the Halifax Antiquarian Society to treat all payment I have made since 6 April 2000 and all donations I make from the date of this declaration until I notify you otherwise as Gift Aid Donations.

Amount Enclosed: £
Signature: ...............................................................

Notes:

 

  1. Please notify the charity if you change your name and address while the declaration is still in force.
     
  2. You can cancel the declaration at any time by notifying the charity - it will then not apply to donations made on or after the date of cancellation or such date as you specify.
     
  3. You must pay an amount of income tax and/or capital gains tax at least equal to the tax that the charity reclaims on you donation in the tax year.
     
  4. If you pay tax at the higher rate you can claim further tax relief on your Self Assessment tax return.
     
  5. If you are unsure whether your donations qualify for Gift Aid tax relief, ask the charity. Or you can ask your local tax office for leaflet IR 113 Gift Aid.
Date: ...............................................................