Membership Application Form

Benefits of Membership:
q  free parking and entrance to Wandlebury
q  free entrance to the Society's other properties       on Open Days (upon show of membership card)
q  free entry to the Society's other events
q  free Newsletter ('The Ring')
q  right to attend and vote at the society's general meetings
q  doing something positive to protect and enhance the amenities and environment of Cambridge

Application form:
If you would like to become a member of the Cambridge Preservation Society please print and complete this form and return to:
Cambridge Preservation Society, Wandlebury Ring, Babraham, Cambridge CB22 3AE (Charity No. 204121).

Make cheques payable to
Cambridge Preservation Society. Payment by Bankers' Order helps reduce our costs. Also if you pay UK income tax, please sign the declaration form. It costs you no more but means the value of your subscription is greatly increased.

Title:                       Initials:
Surname:

Address:



Signature:                          Date:
Tel:
E-mail:
Membership category (
please tick):    Rate/ year

  • Individual (incl. retired and unwaged)    £15
  • Family (2 or more in same household)   £25
  • Corporate                                            £50
  • Life member (single payment)             £150
  • Patron (single payment)                      £300

Subscription enclosed:                            £
Donation enclosed:                                 £
Total:                                                   £

Banker's Order
To (name and branch address at which you hold your account):




Account No.:                       Sort Code:

Please pay to Barclays Bank plc, Woollards Lane, Great Shelford, Cambridge (Code 20-17-19), for the account of Cambridge Preservation Society, No. 50154083 the sum of £
[now and*] on the 1st January each year until further notice from me in writing. This instruction takes the place of any previous Banker's Order payable to the Cambridge Preservation Society from my account.

Name:                            Signature:

Address:



Date:
*  Delete as required

Declaration for UK Taxpayers:

I would like all donations to the Cambridge Preservation Society I have made since 6 April 2000 and all donations I make hereafter to be Gift Aid donations. I will be paying an amount of income tax and capital gains tax at least equal to the tax that the Cambridge Preservation Society reclaims on my donations in each tax year.

Name:
Address:



Signature:
Date:

NB. In accordance with the Data      Protection Act 1998 the information on this application form will be kept on a secure database at the Cambridge   Preservation       Society. No         information held will be divulged to any third party.

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Contact Details:
Cambridge Preservation Society,
Wandlebury Ring, Gog Magog Hills, Babraham, Cambridge CB22 3AE
Phone: 01223-243830 Fax: 01223-413344
Email: admin@cpswandlebury.org