Name

Address

Postcode

Annual subscriptions Due in February

Family £18.00    Individual £12.00    Unwaged £8.00     _____  Donation

Cheques should be made payable to The Ted Ellis Trust or,
please complete the Bankers Order form below

Gift Aid

Membership subscriptions for the Friends are donated directly to the Ted Ellis Trust and if you pay tax, the Trust can reclaim the tax paid by you on your subscription and thus benefit even more if you sign the declaration below:

Gift Aid Declaration
I would like the Ted Ellis Trust to treat all donations I make from the date of this declaration, until I notify otherwise, as Gift Aid donations.

Signature

Date

Notes
1 You must pay an amount of income tax and/or capital gains tax at least equal to the tax that the Ted Ellis Trust reclaims on your donations in the tax year (currently 28p for each pound you give).
2 If in future your circumstances change and you no longer pay income tax and/or capital gains tax equal to the tax that the Trust reclaims, you should cancel your declaration by notifying the Trust (see note 1).
3 Please notify the Trust if you change your name or address.

Bankers Order:

To The Manager (bank's full postal address)
_______________________________________________________________________
_______________________________________________________________________
Please pay to The Ted Ellis Trust
(Barclays Bank, Bank Plain, Norwich.  20-62-53.  Account No.30332909)
the sum of ___________________________________________ (please write in full)
on _____ /_____ /20_____ and thereafter annually on the same date each year, up to and including ____________________________ (please specify date of final payment or put ‘until further notice’)
Name of account to be debited _________________________________________
Account no. ________________________________________________________
Signed ____________________________________ Date ___________________