Registered Charity No: 240854

SHCT

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Staffordshire Historic Churches Trust

Membership Application Form

We do hope that you will wish to become a member of the Trust. Please download the form set out below and send to:

The Hon. Treasurer, Staffordshire Historic Churches Trust,

11 Mavesyn Close, Hill Ridware, Rugeley, Staffordshire, WS15 3RA.

In HTML format. In this format, to print off the form, connect and switch on the printer, hold your mouse over the form and right click. Then left click "Print" in the dialogue box.

Staffordshire Historic Churches Trust

Form of Application for Membership

I/We ........................................................................

of   ........................................................................

    ........................................................................

    ........................................................................

__ Wish to be enrolled as a member of the above Trust.

__ Wish to subscribe £   a year (minimum £10 per person) and understand that it is renewable each year on the anniversary of the date shown below.

__ Would like to complete a Bankers Order for my subscription.

Enclose cheque/P.O. for my first year's subscription made payable to:

Staffordshire Historic Churches Trust.

__ As a taxpayer I would like to make a Gift Aid declaration.

__ Please indicate by placing a (x) as appropriate

Signed  ..........................................................

Date  .............................................................

Send to: The Hon. Treasurer, Staffordshire Historic Churches Trust,

11 Mavesyn Close, Hill Ridware, Rugeley, Staffs. WS 15 3RA.

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