Membership application
form
Name in full:
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Title (Dr. Mr. Mrs. Ms. etc.), degrees & awards:
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Address for correspondence:
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Address for delivery of publications (if different from
above):
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Telephone number and/or email address (in case of queries):
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I apply for membership of the London Topographical Society for calendar
year ............ and enclose my first subscription (UK £20;
abroad £25) and/or the completed Standing Order Mandate.
Signature:
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Date:
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We would be grateful if UK taxpayers would sign the declaration below as we can reclaim the tax paid.
Gift Aid Declaration
I want the London Topographical Society to treat as Gift Aid donations
all payments made since 6 April 2000 and all future payments until
further notice. I know that I must pay an amount of income tax and/or
capital gains tax at least equal to the amount reclaimed by the Society
in the relevant tax year.
Name:
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Signature:
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Date:
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Please send the form to the Society at 7 Linden Avenue, Dorchester, Dorset DT1 1EJ, UK.