Membership Application or Renewal Form I/We wish to apply for/renew membership (delete as appropriate) and enclose my/our payment. Cheques should be payable to The Haywards Heath Society and sent together with this form to The Treasurer at the address shown overleaf. NB If you pay by Bankers Order you need do nothing to renew your membership but you will need to amend the amount payable following the increase in subscription levels. Name (1st Member): Name (2nd Member): Address: Post Code: Telephone Number: email address: (The following paragraph may be deleted if it does not apply) I/We wish any donations or subscriptions I/We have paid to the Society since 6th April 2000 and all donations or subscriptions I/We pay hereafter to be treated as Gift Aid donations. I/We confirm that I/We currently pay an amount of income and/or capital gains tax at least equal to the tax reclaimable on these donations/subscriptions. Signed (1st Member)………………………………………………………………………… Signed (2nd Member)…………………………………………………………………… Any member not currently paying by Bankers Order and wishing to do so should obtain a form from his/her own bank. The Society’s details needed are:- Account No 01003569 Account Name: The Haywards Heath Society; Sort Code: 40-23-27. Gift Aid Most of us pay at least a small amount of income tax on our salary or pension and the Society can reclaim the tax relating to your subscription or donation. All you need to do is to fill in the detail on the Application/Renewal form when returning it to the Treasurer. If all our members were able to agree to this, our annual income would be increased by about £150, so it would make a big difference to our finances. Email address: if you have an email address that we could use to contact you then we could, on some occasions, make savings on our postage bill. Nicola Serdiuk, Hon Treasurer, The Haywards Heath Society, 57 Victoria Road, Haywards Heath, West Sussex. RH16 3LZ Annual Subscription - £12.00 Pensioners, students, unwaged & children - £10.00 Life Membership - £60.00