Friends of Poulton Membership Form
  
Title................... Forename/s.............................................................................................................
Surname.........................................................................................................................................................

Title................... Forename/s.............................................................................................................
Surname.........................................................................................................................................................

Address..........................................................................................................................................................
............................................................................................................... Post Code.........................

Email Address...............................................................................................................................................

Tax payers: Please note that recent changes in the UK tax law now enables registered charities to reclaim 28p from the Inland Revenue for every £1 you donate. This costs you nothing, all we ask is that you sign the declaration below.
Donation £..............................   Please tick box if you pay UK tax
Declaration
I request that The Poulton Project treat this as a donation for membership of The Friends of Poulton and all subsequent renewal payments, as Gift Aid Donations.
Signature of the person making the donation..............................................................................................
Address if different from above..............................................................................................................

Please make your cheques mayble to The Poulton Research Project and post to:
Friends of Poulton, c/o 17 Canadian Avenue, Hoole, Chester, CH2 3HG

Thank you

For your peace of mind - Data Protection Act 1998. Your details will be stored electronically as part of our FOP Membership and Gift Aid scheme. They will not be used for any other purpose.
The Poulton Research Project is a registered Charity Number 1094552