MEMBERSHIP FORM
Subscription fees: Life Membership £100 | Family Membership £15 | Single Membership £10.00

Please print out this page and mail it to: Paul Raby, Membership Secretary, 28 Ashtree Road, New Costessey, Norwich, Norfolk, UK, NR5 0LS. The reason we cannot process the application purely over the Internet is that we need a signature for the Declaration below, and for the Bankers Order if that is your preferred method of payment. Many thanks.

Mr Mrs Ms Surname

Address:

Telephone No.

I wish to pay by cheque cash Bankers Order (please check appropriate box)

Bank details if paying by Bankers Order:

BANKERS ORDER FORM

I,

Of

Agree to pay £ 0.00 10.00 15.00 annually, commencing from (dd/mm/yy)

Signed:...................................................................

To the Manager, Bank

Bank Address:

Account No: Sort Code: - -
Please pay to: HSBC, 18, London St., Norwich, NR1 1DA
Sort Code 40-35-10 for the Raptor Trust a/c no. 61129341

GIFT AID

Are you a UK tax payer?
If So, we could claim extra money from the Government on top of your subscription - It won't cost you a penny! All you need to do is tick this box.................
I would like the Raptor Trust to reclaim the tax on my subscription. I have paid an amount of UK income tax or capital gains tax equal to any tax reclaimed.

Signed:.................................................................. Date:.............................