Application

Application Form

Membership is £10 a year, or £15 for two people. A year's membership runs from October to September, but if you join after 1 May, you are not asked to pay again until 1 October in the following year.

* Indicates required field

Single or Joint Membership? *

Individual Membership Joint Membership (same address)

Your Name *

First

Last

Second Member's Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Payment
Please pay your first year by bank transfer or setting up a standing order We will then follow up to complete your registration and finalise all the details of your membership. Please be sure to include your name in the reference field as this is the only way that we can trace your payment.

Account Name: Stamford Civic Society
Bank code: 40-43-05
Account number: 00784591

It also helps us if you are able to Gift Aid your membership donation as this allows us to reclaim an additional £2.50 on single membership and £3.75 on joint memberships from HMRC. If you are able to do this, please check the Gift Aid Declaration box below,

Gift Aid Declaration *

_Please treat all gifts of money that I have made to Stamford Civic Society (Regd. Charity No. 242571) in the past six years and all future gifts of money that I make from the date of this declaration as Gift Aid donations. I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1 that I give on or after 6 April 2008.

I agree to receiving marketing and promotional materials

Submit