Friends of University Art and Music (Leeds)

Membership and Gift Aid

For new Friends and membership renewal

(if you are renewing your membership and have already completed a gift aid declaration there is not need to do so again)

Please enrol me/us as Friends of University Art and Music (Leeds)

for the season 1 September – 31 August.

Name/s………………………………………………………………………………………………………………………………………………………………….

Home Address ……………………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………………………………….

………………………………………………………………………..   Post Code ……………………………………..

Tel………………………………………..

Email *……………………………………………………………………………………………………….

* Please include an email address if you are happy for us to use it as it saves postage costs

I enclose my subscription for: (please tick)

Annual subscription: Single £24; Double £36                                  □

Ten year membership: Single £210; Double £340                          □

Life membership: Single £315; Double £470                                    □

Students and those aged under 30: A reduced subscription of £10      □

Please accept my donation of £ ………….

I enclose a cheque payable to FUAM (Leeds) for £ ………….

Boost your donation by 25p of Gift Aid for every £1 you donate.
Gift Aid is reclaimed by the charity from the tax you pay for the current tax year.  Please complete the declaration if you would like us to claim Gift Aid. Your address is needed to identify you as a current UK taxpayer.

 A gift aid declaration can be found below.


Gift Aid declaration – multiple donations

In order to Gift Aid your donation you must complete the details below:

I want to Gift Aid my donation of £    ……………… and any donations I make:

in the future □  or have made in the past 4 years □

to: Friends of University Art & Music (Leeds),

registered charity 1094566

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 year it is my responsibility to pay any difference.

My Details (please print)

Title ………..   First name or initial(s)……………………………….   Surname……………………………………………………………………

Full Home Address………………………………………………………………………………………………………………………………………………..

…………………………………………………………………………………. Postcode ………………………

Signed    ………………………………………………………………………..

Date …………………………….

Please notify the charity if you

If you pay Income Tax at the higher rate or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.

Please return this form to:

Mrs Carol Gleisner, FUAM (Leeds) Membership, 10, Helmsley Drive, LEEDS, LS16 5HY

 

Thank you for your support.


A PDF version of this form can be found HERE

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