Membership Application Form

Statutory fields marked *

Application for Membership

PLEASE NOTE: This form cannot be saved. If you wish to keep record of your form, please print once completed.
Title *
Foreneme(s) *
Surname *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone *
Email *
Name of second member. A second member living at the same address may join at a reduced rate (Joint membership. One mailing).
I wish to belong to the following branch(es) of the Society (two may be chosen). *
East AnglianEast MidlandsLondonNorth AmericaNorth WestScottishSouthernWest MidlandsYorkshire and North EastNo branch
Payment The Society's preferred method of payment is by Standing Order. On submitting this form you will be re-directed to the payments page where all payment details can be viewed. For new members paying by Standing Order subscriptions are not due until 1 January.
Please select one of the following. *
Standing OrderChequeBank TransferCredit/Debit CardPayPal
Where did you learn about the Elgar Society?
Gift Aid Declaration (UK taxpayers only) Name of Charity: The Elgar Society (Charity No. 298062)
TREAT ALL GIFTS OF MONEY THAT I MAKE TODAY AND ANY DONATIONS I MAKE IN THE FUTURE OR HAVE MADE IN THE LAST FOUR YEARS AS GIFT AID DONATIONS.
Name
Home address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Email Address
Please inform the Elgar Society if you:
Wish to cancel this declaration
Change your name of home address
No longer pay sufficient tax on your income and/or capital gains
You must pay an amount of Income Tax and/or Capital Gains Tax for each year (6th April one year to 5th April the next) that is at least equal to the amount of tax that the Elgar Society will reclaim on your gifts for that tax year. The Elgar Society will
reclaim on your gifts for that tax year. The Elgar Society will reclaim 25p on every £1 that you give. If you pay less Income Tax and/or Capital Gains Tax it is your responsibility to pay any difference.
If you pay Income Tax at the higher rate, you must include all of yourGift Aid donations your Self Assessment tax return you wish to receive the additional tax relief due.

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Membership Application Form

Application for Membership

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