[Back to Join page]    Lewisham Local History Society Membership Application / Renewal Form (2019)

Please print out this form (fits on A4 paper, portrait mode) and post it to:
Sylvia Eley, 5 Parkham Court, 11 Shortlands Road, BR2 0JF

Postcode     Phone   

I enclose a cheque / postal order made payable to the Lewisham Local History Society in the minimum amount of £10 Standard, £15 Family or £15 Institution, plus an extra donation of £ ________________

The Society needs to refresh its Gift Aid declarations to reflect the new official wording and to update our records regarding members’ Gift Aid status. If you are able and willing to Gift Aid your subscriptions and donations please complete the Gift Aid Declaration in Section A below, even if you have previously completed a declaration. If not (for example because you are not paying enough tax) please complete Section B. After completion please return the form to the Membership Secretary at your earliest convenience.
Please ensure that you have filled in your name, address and other details in the boxes at the top of this Renewal Form.

Section A – "YES" to Gift Aid

Lewisham Local History Society (LLHS) is a charity which is able to claim Gift Aid on donations received, at the rate of 25p for each £1 donated, provided they are supported by a valid declaration. In this context donations include membership subscriptions. Your address (including postcode) is needed for identification purposes.

I want to Gift Aid my current subscription/donation to LLHS and any subscriptions/donations I make in future or have made to LLHS in the past four years. I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.

I would like the Lewisham Local History Society to reclaim tax on all donations I have made since 6 April 2000 and on all further donations I may make until I notify you otherwise.
Please ensure that you have filled in your name, address and other details in the boxes at the top of this Renewal Form.
Signed    Date   

Section B – "NO" to Gift Aid

Signed    Date   

Please notify the Membership Secretary if you wish to cancel this declaration, if you change your name or address or if you cease to pay sufficient Income or Capital Gains tax. If you pay tax at the higher rate and wish to claim any additional relief due you must include all your Gift Aid donations on your Self-Assessment Tax Return or ask HMRC to adjust your tax code.