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EPBPG MEMBERSHIP APPLICATION FORM
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Name.

Address

 

Postcode

Telephone

Email

I wish to join the EPB Preservation Group at the following rate (Please circle applicable rate)

Ordinary (1 Year) £15

Senior (1 Year) £11

Student/under 16s £11

Family (See note) £20

Note. Family rate is for 2 adults and up to three children, please give forenames and date of birth of children.

I enclose a cheque/postal order payable to the EPB Preservation Group

for £________, including an optional donation of £_________.

I wish to make regular donations via standing order (tick here) ________ (we will contact you with further details)

GIFT AID If you pay income or capital gains tax in the UK the EPB Preservation Group (charity 1132225) can claim gift aid on donations and subscriptions, increasing their value to us by 25%. Please sign and date below to enable us to do this at no cost to yourself.

Signed_____________________________ Date______________

Please post completed form to EPBPG Membership , 25 Amber Close, Earley, Reading. Berkshire. RG6 7ED.