RUGBY FAMILY HISTORY GROUP

 

 

 

 

 

MEMBER OF THE FEDERATION OF FAMILY HISTORY SOCIETIES

 

 

 

 

 

MEMBERSHIP APPLICATION 2004-2005

 

 

 

 

 

 

 

 

 

 

 

Charity No 1101192

www.rugbyfhg.co.uk

 

MEMBERSHIP FEE

U.K.   £8.00

OVERSEAS £10.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SURNAME

 

 

TITLE

 

 

 

 

 

 

 

 

FORENAMES

 

 

CHEQUE

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

CASH

 

 

 

 

 

 

 

 

 

 

 

 

MEMBERSHIP NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ENTERED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POSTCODE

 

TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Email Address

Please use one character, number, space etc. per box

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

aRE YOU ARE A RE-JOINING MEMBER?

Yes

No

 

Have any of your details changed since last year?

Yes

No

 

please INDICATE OR HIGHLIGHT ANY CHANGES AS THIS WILL ASSIST IN COMPILING THE MEMBERSHIP RECORDS. (Please advise the Membership Secretary of any future changes)

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 
Gift Aid

 

 

Please note that anyone, who pays income tax, by completing this simple Gift Aid Certificate, can allow the Charity to claim back the basic rate tax, which he or she has already paid.

 

 

 

 

 

 

 

 

 

 

 

 

 
Gift Aid Certificate

 

 

Please treat all my donation and subscription for Membership of the Rugby Family History Group (RFHG) on and after date of this declaration, as a Gift Aid Donation and I authorise RFHG to reclaim the appropriate amount of tax. I note that as a donor I must pay or have paid an amount in income tax or capital gains tax equal to the tax reclaimed by the charity.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signed

___________________________

Date

_____________________

 

 

 

 

 

 

 

 

 

MEMBER INTERESTS

 

 

 

 

 

 

 

 

 

 

 

 

 

ARE YOU A MEMBER OF ANY OTHER SOCIETIES (Please list)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RESEARCHING

 

NAME

LOCATION

PERIOD

 

TOWN

COUNTY / COUNTRY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Membership Secretary

Mr Graham Gare. 103. Glebe Crescent, RUGBY Warwickshire. CV21 2HQ.           Tel.  01788-330296

email: - 11.freeserve.co.uk

 

 

 

As required by the Data Protection Act all Members, when joining the RFHG, accept that details disclosed on the membership form will be held on computer for the benefit of the RFHG. Member’s interests will be published from time to time as deemed appropriate by the Committee.

 

 

 

An work done for or on behalf of the Group will remain the copyright of the Rugby Family History Group