HOS Membership Application Form

I/We wish to join HOS (please tick category):
Membership runs from January to December.

Ordinary Member £12.00  
Joint/Family Members £12.00  
Junior Member (under 18) £5.00  

 

Title Initials
Surname
Address

 

Postcode

Date of birth (Junior Members under 18):
Signed: Signature of parent or guardian if Junior

Important: Please also fill out the Gift Aid declaration below

Method of Payment
Payment by cheque only please (made payable to Hampshire Ornithological Society). Sorry, we cannot accept credit cards and do not operate a Direct Debit scheme. A standing order form will be enclosed with your membership pack in case you wish to renew using this method.

Data Protection
Membership records are held on a computer and are covered by the Data Protection Act. The records are kept strictly confidential by the Society and are not made available to third parties.

Gift Aid Declaration to HOS
If you are a taxpayer we can increase the value of your subscription by £3 by reclaiming tax from the Inland Revenue. Please help us by signing the declaration below.

I wish HOS (Charity No. 1042309) to reclaim tax on my subscription and all subsequent donations and subscriptions I make to the Society.
Print FULL name:
Signature:
Date:

 

For office use: Recd Sent Code

Please return form to:

Kay Shillitoe,  ‘Westerley’, Hundred Acres Road, Wickham,  PO17 6HY.