Membership Application Form
I wish to become a member of the Rural Theology Association.
Individual membership £15.00 p.a.
Organisation membership
and library subscriptions £30.00p.a.
Overseas membership £25.00 p.a.
I also enclose a donation of £...................
Total amount £.................
Please make cheques payable to the Rural Theology Association and send them with this form (including the Banker's Order below) to:
The Revd Caroline Pinchbeck, RTA Secretary, The Rectory, Newnham Lane, Eastling, Faversham, Kent ME13 0AS 01795-890487
Name (Block letters)............................................
Address........................
...................................
.............................
Email address..............................
Telephone .....................................
I am a tax-payer and wish the tax paid to be recovered under the Gift Aid scheme (delete if necessary)
Signed.....................
Date................
It would be a great help if you could pay by Banker's Order. An appropriate form follows. We also accept CAF or other Charity Vouchers.
Our Registered Charity Number is 327029
I would like to receive the Newsletter electronically: YES/NO
I am prepared to have my name and address published in the annual membership list: YES/NO
Banker's Order
To (name and address of own Bank)
Please pay to National Westminster Bank, Driffield Branch (sort code 60-07-05) for the account of the Rural Theology Association (account no. 01162691)
the sum of £................................. (in figures)
(.................................................................) (in words)
on......................................20...... (insert date)
and a like sum each following year until such time as this Banker's Order is varied or cancelled.
Signed.................
on the............................day of .....................................20..........
Account Number
Account Name
