Please print out and return this form (or the pdf version attached below)

The Society is a registered charity: no 272098

Categories of membership and subscriptions
Ordinary members £30.00
Associate members £5.00
Institutional members : Please contact Office for subscription prices

Junior members (over 16 and under 21 years) £6.00 (date of birth: __________________ )

Student members (over 21 and under 26 years) £12.50 (date of birth: _________________ )

Please enrol me as an Ordinary/Associate/Junior/Student member/this organisation as an Institutional member/of the Surrey Archaeological Society.

Name (Mr/Mrs/Miss/Ms etc) __________________________________________________________

Postal address _____________________________________________________________________

_________________________________________________________________________________

______________________________________ Postcode/Zip code ___________________________

Email ____________________________________________________________________________

Interests __________________________________________________________________________

I/we consent to this personal data being held on computer, on the understanding that it will be used solely by the Society and will not be divulged to any other person or organisation. I/we agree to be bound by the Society's Memorandum and Articles of Association (attached below).

I understand my next subscription will be due in April 2018.

Signed _______________________________________  Date _____________________________

GIFT AID: I am a UK taxpayer and want Surrey Archaeological Society to treat all my donations, including membership subscriptions, made from 6 April 2011 as Gift Aid donations until further notice. I confirm I have paid or will pay an amount of UK Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand Surrey Archaeological Society will reclain 25p on every £1 that I give on or after 6 April 2011.

Signed____________________________________Date______________

Please return this form together with a cheque made payable to: Surrey Archaeological Society to:

The Membership Secretary, Surrey Archaeological Society, Castle Arch, Guildford GU1 3SX