Membership Application Please Tick applicable box: Individual Membership (suggested donation £25) Family Membership (two adults residing at the same address & children 18 or under – suggested donation £40) If you’re interested in Corporate Membership, please contact us directly at: firstname.lastname@example.org to discuss. Your Name (required) Family Membership (add second adult’s name) Boat Name Your Address Your Postcode Your Telephone Number Please tick the box if you’re in agreement that: we may use your postal address and/or phone number it to administer your membership and contact you about your membership, your boat, or in an emergency. Your Email Please opt in to receive BHA’s email news and information on events, meetings, security alerts etc Yes No Please opt in to receive Navigation Warnings Yes No GIFT AID FORM 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. Your address is needed to identify you as a current UK taxpayer. In order to Gift Aid your donation you must tick the box below: Gift Aid – Yes Gift Aid – No 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: Name of Charity BLAKENEY HARBOUR ASSOCIATION 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. Please notify the charity 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. Your Details Title (required) Initials / First Name (required) Surname (required) Address Postcode Date HOW TO PAY: Before submitting the form below, please make a bank transfer to TSB: Sort code 30-94-34 Account No: 21707768 and then press the send button below. Please use your SURNAME as a reference if paying direct to the bank. If you would like to pay by standing order you have to send the standing order form by post. To do this go back to the previous page and print out the standing order form from the options and follow the instructions.