Name ........................................... Initials.............. Title ...................
Name of additional member ......................................................................................
Address ...................................................................................... Post/Zip code ...........................................
Please pay by cheque/postal order, credit card or standing order - just complete the appropriate section below. Overseas members must pay in sterling. If you wish to take out life membership complete the section at the foot of this page and enclose your cheque or include your credit card details. In all cases please complete the Gift Aid form if you pay UK tax.
(cheques/postal orders payable to the Thomas Hardy Society)
(ii)In all cases please Overseas members must pay in sterling. However, if you are an Overseas member or if you are a UK member who wishes to take out life membership you may pay by credit card (not American Express)
Card number
Card expiry date Card type .....................................
Amount £....................... Signature .....................................
BANKER’S ORDER
To...................................................................................................Date: ...........................
Address of Bank..............................................................................................................................
Post Code of Bank.....................Account No...............................Sort Code ......... - ...........- .......
(Please give name and address of your own bank, and your account number)
Please pay to the Thomas Hardy Society, at Lloyd’s TSB Bank, Dorchester, (Account no. 202283360, Code 77-50-30) the sum of £...............(Enter amount to be paid) commencing now; and then on 1 April annually thereafter until further notice in writing.
Signature...................................................................................................................................................
Name in Capitals ........................................................................................................................................
Address ......................................................................................................................................................
........................................................................................................................................................
................................................................................... Post Code.....................................................
Name (please print) ..................................... .....................................
Address ..................................... .....................................
..................................... .........Postcode............................
I am a UK tax payer and I want the Thomas Hardy Society (a Charity) to treat all donations I have made since 6 April 2000 and all donations I make from the date of this declaration as Gift Aid donations (until I notify you otherwise).
Signed .....................................Date .....................................