APPLICATION FOR MEMBERSHIP

TITLE: Mr / Mrs / Miss /Other…………………………………………………………………..

FULL NAME……………………………………………………………………………………………………………………………………………………………………

ADDRESS…………………………………………………………………………………………………………………………………….…..

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POST CODE…………………………………………………………………………….

Individual Membership Fee £10.00, Couples Annual Membership £18.00

I / We wish the Charity to treat all donations which I / We have made from the date of this declaration as Gift Aid

I / We pay Income Tax at the standard rate

Signature………………………………………………………………………………………     DATED…………………………………………………………………

Please print out and return this form to:

The Hon. Membership Secretary,

The Friends of Kikrkandrews-on-Esk Church.

Craig

Westerkirk

Langholm

DG13 0NZ