Victoria Baths
Friends Membership 2015
Title Mr/Mrs/Ms……… Name(s) ………………………………………………………………………………
Address…………………………………………………………………………………………………………..
………………………………………………………………………………………Postcode…………………
Telephone……………………………………………Email……………………………………………………
No. of
people
Subscription rate
I would like to become a Volunteer and be actively involved
Restoration Supporter rate of a minimum £3 per month by Standing Order
Full annual rate subscription of £18 per person if you are waged paying
by Standing Order
Amount
£
Please see
page 2
Please see
below
Please see
below
Full annual rate subscription of £20 per person if you are waged paying
by cheque or cash
Reduced annual rate subscription of £5 per person if you are unwaged
I would like to make a one-off donation
Total cash or cheque (made payable to Victoria Baths Trust)
I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax in the tax
year to 5 April that is at least equal to the amount of tax that all the charities or Community
Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts. I understand that other
taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of
tax on every £1 that I give.
Please tick if
applicable
Standing Order
Either: I have created my Standing Order using online / telephone banking
Or:
Your bank.............................................................................................. (e.g., Cooperative Bank plc)
Address of your bank...................................................................................................................
..................................................................................................................... Postcode..................
Your name(s) (as appears on your account).................................................................................
Account Number ....................................................... Sort Code …………………………………
Please pay the Co-operative Bank, Olympic House branch
For the credit of The Manchester Victoria Baths Trust
Sort code: 08-92-50
Account number: 65035968
If you choose a specific date for the first payment, please allow at least 2 weeks from when you send your mandate
The sum of £...................................
Now / or on..................................... (date of your first payment)
And thereafter on the same day every month / year (please delete as required)
Membership
For bank use – please quote the following reference when making payments
Until you receive further notice from me and debit my/ our account accordingly
Signature …………………………………………………………………… Date ………………………
Please return this form to: Victoria Baths, Hathersage Road, Chorlton on Medlock, Manchester M13 0FE
If you have any queries, please contact us on 0161 224 2020 or friends@victoriabaths.org.uk
HH/SH 10.02.15
For office use only: Friends Welcome Pack provided
Page 1
Volunteering
at Victoria Baths
Your name
Why are you
interested in
volunteering at the
Baths?
What do you want to
be involved in?
If you have
volunteered before,
please give details
Which days and times
are you available?
If you have
qualifications or you
are studying at the
moment, please give
details
Disclosure and
Barring Service
checks (was CRB)
If you will be working with children or
vulnerable adults, are you willing to
complete a DBS registration form?
Emergency contact
details (please provide
a name, address &
phone number of a
family member or
friend)
Signature
(Not required if you return the form electronically)
Date
Volunteer Details & Confidentiality
The Trust asks for the information above to provide a starting point for your volunteering at the Baths and for future
reference. At the end of your volunteering, you can ask for the information to be deleted and this will be done after
5 years as a matter of course.
Data Protection
The Trust is registered with the Information Commissioner’s Office. In compliance with the Trust’s Data Protection
Policy, your information will be kept as securely as we are able and will only be used for volunteer related activities.
In turn, you are required to respect the information of other people.
Please return this form to: Victoria Baths, Hathersage Road, Chorlton on Medlock, Manchester M13 0FE
If you have any queries, please contact us on 0161 224 2020 or friends@victoriabaths.org.uk
GW /HH/SH16.03.14
Page 2