Supporting Member Application Form Title First Name Surname Home Address Postal Code Date of Birth Email Address Occupation Additional Skills Mobile No. I apply to be a Supporting Member of Essex Cultural & Youth Society, charity registration number 1173188, (“the Charity”). I have completed the Annual Charitable Donation Standing Order Form in favour of Essex Cultural & Youth Society sort code 20-12-21, a/c number 73697150 I will support the Objects of the Charity as set out from time in the Articles of Association, which are publicly available on the Charity’s website. Membership will carry on until it is terminated by me or by the Charity. Membership can be cancelled by me at any time by informing the Charity. Donations are non-refundable I understand that my membership may be terminated by the Charity if I do not pay the annual donation set out in the Annual Donation Standing Order Form or in the opinion of the Trustees I act contrary to the interests of the Charity I wish to be acknowledged on the Charity’s website as a Supporting Member (tick if applicable) I want to Gift Aid my donations to Essex Cultural & Youth Society I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference. Name / Signature Date Membership is personal and cannot be transferred. Supporting Members are entitled to attend quarterly meetings with the Trustees and the Charity’s management committee to discuss the operations of the Charity including its accounts, its governance and its plans for the future. Use of your data: We will never share your data with anyone else.