BUCKINGHAM CANAL SOCIETY

Membership Application Form (Internet)

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Please fill in and post with your remittance to:

The Membership Secretary, Buckingham Canal Society, 96 Gaddesden Crescent, Wavendon Gate, Milton Keynes, MK7 7SQ

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The annual membership fees are:

Single Member £9.50, Family Membership £15.00, Youth Membership (under 18) £3.00

Concessions £5.00 (each member), Corporate Membership £35.00

I/We wish to join the Buckingham Canal Society and enclose the following:-

Annual subscription £ _____________

Donation £ _____________

Total £ _____________

Cheques payable to Buckingham Canal Society please

I/We agree to be bound by the Constitution of the Society and agree to my/our membership details being recorded on a computer.

Signed: _____________________________ Date: ____________________________

MEMBERSHIP DETAILS

Name(s)  _____________________________________________________________

Address:  _____________________________________________________________

_________________________________________________ Postcode ____________

Phone number: _____________________________________

Email: ____________________________________________

I am willing to take the newsletter from the website: Yes/No

Gift Aid Declaration

If you pay UK tax, the Gift Aid scheme allows BCS to reclaim the tax you have paid on your subscriptions. Please take advantage of this scheme, which costs you nothing but is of great benefit to the Society, by signing the declaration below.

(1) I pay UK tax.

(2) I wish Buckingham Canal Society to treat the enclosed annual subscription and all future subscriptions and donations as Gift Aid donations.

Signed: _____________________________ Date: ____________________________