Please complete this form and send it with your remittance payable to OLDLAND MILL TRUST to :

  

I/we wish to make application for membership of Oldland Mill Trust and enclose a remittance:

Life Membership - Single £50 Couple £75 £________

Volunteer (Subscription optional) £________

Family Membership £10 £________

Individual Membership £5 £________

I am adding a donation. £________

I wish to take _____ 100 Club tickets @ £12 each £________

Total remittance £________

Please treat as Gift Aid donations all qualifying gifts of money made today and in the future

I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify.

Please use capitals

Title_______First name or initial(s)_______________Surname_____________________

Full home address__________________________________________________________

___________________________________________________________________________

Postcode ____________________________________ Date __________________________

Signature______________________________E-mail_____________________________

Please tell Oldland Mill Trust if you want to cancel the above declaration, change your name or address, or no longer pay sufficient tax on your income or capital gains.

100 Club
The Oldland Mill Trust "100 Club" will be running for the fourth year, under the Gambling Act of 2005, with a license from Mid Sussex District Council. For 2011 - 2012 we rose to 111 Members.

For an annual contribution of £12, until we have 25 members, there will be one monthly prize of £12 increasing to two when we reach 50 members, three at 75 members and at 100 members, 4 monthly prizes of £12. For members joining after the first draw, the annual contribution will reduce by £1 for each month they have missed the draw.

The first draw will be on Thursday 5th July 2012 and on the first Thursday each month until June 2013, at Oldland Mill in the presence of the Volunteers. Payment will be by a cheque handed to the winning member or posted to the address given for correspondence. The results will be on displayed on the website, at the Mill and in the Newsletter.

If you wish your tickets to be in the name of someone other than yourself please give the name and correspondence address on the back of this form.

Correspondence
We know that many Members use e-mail and it would help OMT to increase the usage for our communications. May we ask you to indicate your preference?

I would WISH / NOT WISH to receive correspondence by e-mail.