Please complete the form below to pay for your membership by card. For non-card payments, use our offline membership application form.

Membership Application Form

First, please select the type of membership required.

Membership type

If you plan to select Gift Aid below, Person 1 must be the Taxpayer.

Your details

Person 1

Mr, Ms, etc
Name
Name
First
Last

Person 2

Mr, Ms, etc
Name 2
Name 2
First
Last
Address
Address
Town/City
County/State/Province
Postcode
Country

Payment details

Cost = £7.50 for a single person

You can optionally add an additional donation.

Cost = £10.00 for joint membership.

You can optionally add an additional donation.

Additional Donation

Charity Gift Aid Declaration

If you consent to Gift Aid, Friends of Pittville will be able to reclaim the tax you have paid on your membership, or any additional donation, boosting the income we receive to support the work that we do.

Gift Aid

By ticking this box I confirm that I am a UK taxpayer living at the address above and understand that if I pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference.

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.

By ticking this box I confirm that I (Person 1 on this form) am a UK taxpayer living at the address above and understand that if I pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference.

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.

Please notify Friends of Pittville if you:
(1) want to cancel this declaration, (2) change your name or home address, or (3) no longer pay sufficient tax on your income and/or capital gains.

Data Protection/use of data

We will only contact you in relation to activities as set out in the Friends of Pittville Privacy Notice.

Total to pay

Credit or Debit Card