Full Name/s (Mr./Mrs./Miss/Ms.)
.
Date
I wish to become a member of The League of Friends of the Stroud Hospitals and Health Centre, and enclose my subscription.
(£1 or more if you prefer)
You may wish to pay by Standing Order.
If so please indicate here ( ) and we will be pleased to send you information.
I enclose for the funds a donation of
I want the Charity to treat the above amount as a Gift Aid Donation ( ) Please tick if appropriate
I know that I must pay an amount of income / capital gains tax at least equal to the tax the charity reclaims on my donation.
I do not want the Charity to treat the above amount as a Gift Aid Donation. ( ) Please tick if appropriate
Please return this form to the Membership Secretary:
Mrs Diane Clewes,
Membership Secretary,
1, The Knoll,
Randwick,
Gloucestershire
GL6 6JA
Thank you for your support
