Membership Application

IMPORTANT PLEASE READ:
When you have submitted your application, you will receive a further email from the Membership Secretary confirming your permit is valid, which will include your registration number, commencement and expiry dates. You will receive an email confirmation of your payment. HOWEVER YOUR PERMIT IS NOT VALID UNTIL YOU RECEIVE THE EMAIL FROM membership@wythallcommunityclub.org.uk TO CONFIRM YOUR PERMIT IS VALID. Until such time, you should continue to pay for your parking, or if the club is open, enter your registration in the tablets provided.

Please complete the form and payment below:

Step 1 of 5

Is this for New Membership or Renewal?

Renewal Membership
New Membership

Number of Adult Members

One Adult
Two Adults

Adult Member

Title

Adult Member

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Date of Birth

Example - 22/09/2003

Marketing

Opt-in
Opt-out

Opt-in to receiving emails advising you of Association and Club events, news and updates.

Subscriptions

Subscription fees are determined by the subscription type and the number of members of each subscription type.

Voluntary additional charity donation

We aim to keep our fee rates as low as possible but, if you can spare a little more to help the charitable work of Wythall Community Association, it would be greatly appreciated.

Car Registration Number

Please check the registration number is entered correctly!

Total

£0.00

Giftaid It

Gift Aid allows us to reclaim 25p on every £1 of your subscription that you give to Wythall Community Association and additional donations. Please state that you are happy to do this by declaring here:

I want to Gift Aid the element of the total subscription due to Wythall Community Association, any donation and any similar payments I make in the future. 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 year, it is my responsibility to pay any difference.

Please remember to let us know if you wish to cancel the declaration, are no longer a UK taxpayer or pay insufficient tax.

Giftaid Consent

I want to Giftaid It

Membership Agreement

I/We Agree

I / We wish to apply for membership.

Where applying for Club membership, I / We agree to abide by the Rules of The Club.

Data Protection - Privacy Policy

All information submitted here is for internal use only and will never be shared with other organisations. Instructions on how to opt-out of our email distribution list are included in every email sent out. Please tick the checkbox that you have read and agree with our privacy policy.

Membership Payment

Gift Aid

- - Your donation could be worth even more to the Wythall Community Association through the Gift Aid scheme. Ticking the Gift Aid box on the application form means we can reclaim tax for every £1 you give. To qualify you must pay an amount of income tax and / or capital gains tax at least equal to the tax that the charity reclaims on your donations in the tax year.
  - Please complete all your details clearly above and, if applicable, sign to allow us to claim Gift Aid on your donation.
  - You agree that the element of £12 per person per annum due to Wythall Community Association (Registered Charity No. 243332) and any similar payments you make in future, may be used to claim Gift Aid.
  - Funds raised will go towards the charitable and public benefits.
  - We will share required details, such as your name, first line of address, postcode and age with HMRC as required to claim the Gift Aid.

Adult Member

Additional Adult Member

Junior Members

Proposers

Subscriptions

Giftaid It