GreenSpirit Membership Form to Print Out

To join GreenSpirit, print out and fill in this form and send it together with a cheque (drawn from a UK bank account) payable to "GreenSpirit" to GreenSpirit, 137 Ham Park Road, Forest Gate, London. E7 9LE.

 
 
£

I would like to join GreenSpirit (£24 per annum) - this includes the GreenSpirit Journal and Newsletter

 
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I would like to join GreenSpirit (at £12 per annum) as I could not otherwise afford to join and I live in the UK - this includes the GreenSpirit Journal and Newsletter.

 
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I enclose a donation of
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Total enclosed
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.
 
Please tick
I would like to be included in the Membership Directory
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I would like to be included in the Email Information List
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Please use Block Capitals
 
Name: ___________________________________
Address: ___________________________________
  ___________________________________
  ___________________________________
Post Code: ___________________________________
Telephone Number: ___________________________________
Email Address: ___________________________________
 
Where did you hear about GreenSpirit? ________________________________________
 
Gift Aid:
GreenSpirit benefits greatly from the Gift Aid scheme. If you are in the UK and pay tax, please complete the declaration below. The only condition is that you should be paying tax at least equal to your subscription.
 
Gift Aid Declaration:
I agree to my subscriptions and/or donations being treated by you as Gift Aid. I undertake to inform you if I cease to pay Income Tax.
 
Signed: ______________________________ Date: _____________
 

To pay by standing order, click here for a form to print off

Please send this form to: GreenSpirit, 137 Ham Park Road, Forest Gate, London. E7 9LE.