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Membership subscriptions & donations

I would like to donate £ per year/month (delete as appropriate)

Please give names and date of birth of children, for Family or Watch membership Title First Name Surname Date of Birth

Partner Title First Name Surname Date of Birth

Children First Name Surname Date of Birth

Address

Postcode

Email

Daytime Telephone No Evening Telephone No

Gift Aid Declaration  I confirm Scottish Wildlife Trust may claim Gift Aid on any donations I have made in the last 4 years and in the future until I cancel this declaration. I pay enough Income and/or Capital Gains Tax each year to cover the amount that all charities I donate to can reclaim in the tax year. I understand Council tax and VAT do not count, that Scottish Wildlife Trust will reclaim 25p on every £1 donated (28p on donations up to 5 April 2008)

Signature Date

Now please complete the Direct Debit Instruction overleaf and return the form to:

Membership Department, Scottish Wildlife Trust, Harbourside House, 110 Commercial Street, Edinburgh EH6 6NF

Minimum membership subscription rates:

Annual Monthly Individual (adult) £33 £2.50 Concession £18 £1.50 Joint (2 adults at one address) £46 £3.50 Joint concession £24 £2.00 Family (Includes junior membership) £53 £4.00 World membership £35 Watch (Junior membership only) £18 £1.50

The Scottish Wildlife Trust is a company limited by guarantee, registered in Scotland (registered number SC040247) having its registered office at Harbourside House, 110 Commercial Street, Edinburgh EH6 6NF. It is also a Scottish registered charity (charity number SC005792) Please fill in the whole form Instruction to your Complete using a ball point pen and send it to: Scottish Wildlife Trust Bank or Building Society Membership Department to pay by Direct Debit Harbourside House 110 Commercial Street Service User Number Edinburgh EH6 6NF 9 1 4 9 8 4

Name(s) of Account Holder(s) Reference (SWT use only)

Instruction to your Bank or Building Society Please pay Scottish Wildlife Trust Direct Debits from the account detailed in Bank/Building Society account number this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with Scottish Wildlife Trust and if so, details will be passed electronically to my Bank/Building Society.

Branch Sort Code

Name and full postal address of your Bank or Building Society To: The Manager Bank/Building Society

Address Signatures

Postcode Date

Banks and Building Societies may not accept Direct Debit Instructions for some types of account

This guarantee should be detached and retained by the Payer.

The Direct Debit Guarantee

 This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits  If there are any changes to the amount, date or frequency of your Direct Debit Scottish Wildlife Trust will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request Scottish Wildlife Trust to collect a payment, confirmation of the amount and date will be given to you at the time of the request  If an error is made in the payment of your Direct Debit by Scottish Wildlife Trust or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society - If you receive a refund you are not entitled to, you must pay it back when Scottish Wildlife Trust asks you to  You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

The Scottish Wildlife Trust is a company limited by guarantee,EH4 6HZ. It is also a Scottish registered charity (charity number SC005792)