Please PRINT this form and complete it, together with the Gift Aid Declaration, in BLOCK CAPITALS then return to: The Finance Officer, The Council of Christians and Jews, 5th Floor, Camelford House, 87-89 Albert Embankment, London SE1 7TP I wish to be a member of the CCJ Hillingdon Branch YES / NO
Name:.................................................
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E-mail:......................................@...................................... I have read the Code of Practice and agree to abide by it. Signature:...................................... Date:...................................... GIFT AID DECLARATIONPLEASE COMPLETE THE FOLLOWING IN ADDITION TO THE ABOVEPlease treat my donations to CCJ, as detailed below, as Gift Aid donations (please tick as appropriate) [ ] the enclosed donation of £............[ ] all donations I make from the date of this donation and until I notify you otherwise. Details of Donor:
Title................... Forename(s):............................................
Address:............................................................................ Postcode:................... Signature:...................................... Date:...................................... Please note: You must be a UK tax payer and pay tax equal to or more than the tax deducted from the subscription/donation. You can cancel this agreement at any time by writing to us, but whilst the deduction is in force, you must notify us of any changes in your name and address.
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