APPLICATION FOR MEMBERSHIP/RENEWAL MEMBERSHIP FORM
PLEASE PRINT AND BRING THIS FORM WITH YOUR CHEQUE TO THE ART CLUB STUDIO AT NEWCASTLE ARTS CENTRE, BLACK SWAN COURT, WESTGATE ROAD.
(OR FOR RENEWALS PLEASE put IT IN THE CLUB POSTBOX)
Please delete as appropriate:
I wish to apply for full membership (£132pa)
I wish to apply for Student membership (£40pa)
of the North of England Art Club for the year 2018
I wish to continue use of a locker (£8)
I wish to discontinue my locker use
I would like to have a locker when one becomes available
Note: There is no separate joining fee. If joining part way through the year, you may reduce the fee shown above by one 12th for each full month which has past since January 1st. Your cheque must accompany this form. Thereafter, Annual Fees are renewable each year on January 1st. payable in full, or in two equal installments (cheques must be dated Jan1st and post-dated June 1St and sent in together at the start of the year) No rebates are given if a member resigns during the year unless approved by the Council due to exceptional circumstances.
A cheque (payable to NEAC) is enclosed (please tick)
(Enclose both post-dated cheques if taking advantage of the installment scheme.)
If you are a tax-payer please complete the Gift Aid section. This is an important source of additional revenue for the Club which costs you nothing but adds significantly to the Club's subscription income.
Name: (block capitals please)
Gift Aid Scheme The North of England Art Club is a Registered Charity (No 512764).
I wish this payment to be treated as a donation under the Gift aid Scheme. I confirm I am a UK tax-payer and my payments are at least equal to the amount reclaimed (currently 20p for each £1 given).
Name: (BLOCK CAPS) Signed: Date:
For new members only:
Please supply the name, occupation and contact details of one referee