Member Details

Email address:

Telephone no:

Address:*

(*needed for gift aid)

Freedom Of Choice

We'd love to stay in touch to keep you updated about the exciting projects we have going on, including local wildlife updates, stories and walks on our reserves. We’d like to give you the opportunity to feel part of our amazing community by letting you know about our charitable efforts, fundraising and volunteering activities.

Let us know how you would like to be contacted: (please tick)

Yes I am happy to be contacted via: Post ☐ Email ☐ Telephone ☐

No I am NOT happy to be contacted via: Post ☐ Email ☐ Telephone ☐

Membership Donation Details

We ask for a minimum donation to help cover the cost of membership, though if you'd like to you can, like many

members, choose to round up your donation to help us to do more for nature.

Payment Methods

To help us reduce our administrations costs, we would be very grateful if you could make your membership via Direct Debit, if you are able to.

Please Complete the Details Overleaf for Gift Aid and Direct Debit Membership.

You can contact Sussex Wildlife Trust on 01179 177 270

Membership with Tata Consultancy Services Sussex Wildlife Trust

To complete your half price individual membership application, please fill out the form below and post it to: Membership Team, Sussex Wildlife Trust, Woods Mill, Henfield, West Sussex, BN5 9SD

An annual individual membership to Sussex Wildlife Trust with 50% off will be £19.50, or 12 monthly payments of £1.63.

Full Name:

Yes, I want set up a membership donation of: £ ________ a month/year

☐ I want to pay by Direct Debit and want the payment to be debited from my account to be as above (complete

attached form)

Please read the terms and conditions, available from the webpage provided by TCS, before submitting your form. This half price offer is available for individual membership only, to be paid by direct debit. The amount stated is half the usual minimum subscription rate for individual membership.

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Sussex Wildlife Trust will never sell your contact details to another organisation and never share your data with other charities/organisations for marketing purposes. Your personal details will only be used by Sussex Wildlife Trust, and contracted organisations working on our behalf, or in partnership with us. Should you wish to change your communications preferences at

any time, please let us know by contacting our membership team: email membership@sussexwt.org.uk or call 01273 497532.

Gift Aid Declaration | Boost your donation by 25p of Gift Aid for every £1 you donate

Please notify us if you:

▪ Want to cancel this declaration ▪ Change your name or home address ▪ No longer pay sufficient tax on your income and/or capital gains

If you pay Income Tax at the higher 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.

Full Name: ____________________________________ Signature: ________________________ Date:__/__/____

Name of Account Holder:

Bank/Building Society Account Number:

Branch Sort Code:

Name and full postal address of your Bank/Building Society:

Direct Debit Payments

�DIRECT \,,!JDeblt

Instruction to your bank or building Society to pay a Direct Debit

Service User Number:

I 9 I 1 I 2 s 2 9

Reference

Instruction to your Bank or Building Society.

safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with Avon Wildlife Trust and; if so, details will be passed electronically to my Bank/Building Society.

Banks and Building Societies may not accept Direct Debits for some types of accounts.

Date:

Signature:

Please pay ldlife Trust Direct Debits from the account detailed in this Instruction subject to

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 want to Gift Aid my donation and any donations I make in the future or have made in the past 4 years to Sussex Wildlife Trust.

Wildlife Trust 32 Jacobs Wells Road Bristol 858 lDR

Registered charity number 207005