WORCESTERSHIRE BEEKEEPERS' ASSOCIATION
HAGLEY & STOURBRIDGE BRANCH
MEMBERSHIP APPLICATION FOR 2016
Join the Hagley & Stourbridge Branch by sending this completed form and subscription to the Club Treasurer
PAYMENT IS DUE BEFORE 31 DECEMBER
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CHOOSE YOUR MEMBERSHIP. All memberships run from 1 January to 31December
Enter £
CHOOSE ONLY ONE of the three options below
Click here to OPTION 1 Full Membership £29.00 (BBKA £19.00; WorcesterBKA £2; Bee Disease Insurance
enter text. £2; Branch membership £6.00)
Click here to OPTION 2 Junior Membership £11.50 Beekeepers under the age of 18. (BBKA £9.50;
enter text. WorcesterBKA NIL; Bee Disease Insurance £2; Branch membership NIL)
Click here to OPTION 3 Associate Membership £10.50 Non-beekeepers who want the benefits of branch
enter text. membership (BBKA £9.50; WorcesterBKA £0; Branch membership £1.00)
Click here to Family Membership costs £1. If you have chosen option 1 or 3, do you want a relation to be
enter text. a Family Member and take advantage of our various meetings?
FOR BEEKEEPERS (Options 1 or 2 above) - Bee Disease Insurance is MANDATORY - please
indicate how many hives you wish to insure by entering in the box to the left, the cost of
the maximum number of hives you will keep during the 2016 season.
NIL
1 to 3 hives (included in Membership Fee)
£2.00
£5.25
£7.75
£9.50
Click here to £11.10
enter text. @ £0.50 each
4 to 5 hives
6 to 10 hives
11 to 15 hives
16 to 20 hives
21 to 25 hives
26 to 39 hives
Click here to This is my 2016 membership total
enter text.
See the reverse, or next page, of this form for more details about Gift Aid.
If replying by email please confirm you have read the attached Gift Aid declaration and
confirm you are eligible to participate in Gift Aid. Enter YES / NO in this box.
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to enter
text.
If replying by post please sign and date to authorise your agreement to Gift Aid.
Sign here to authorise Gift Aid …............................................................ Today's Date …..…..........................
By default, Worcestershire Beekeepers' Association will pass your details to the National
Beekeeping Unit so that you may benefit from any disease alerts in your area. Enter “NO” if
you DO NOT want this to happen, otherwise leave blank.
Please make cheques payable to “Hagley and Stourbridge BKA” and send to:
Paul Bennett 5 Montpellier Gardens Dudley DY1 2UQ
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to enter
text.
We want to claim your income tax back on your membership fees
through HMRC Gift Aid.
Gift Aid declaration – for a single donation
Worcestershire Beekeepers' Association, Hagley and Stourbridge Branch
Please treat the enclosed gift of my membership fee as a Gift Aid donation.
I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for the current tax year
(6 April to 5 April) that is at least equal to the amount of tax that all the charities and Community Amateur
Sports Clubs (CASCs) that I donate to will reclaim on my gifts for the current tax year. 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 have given.
Donor’s details are as on my attached membership applicaton.
Please notify the charity or CASC if you:
* Want to cancel this declaration
* Change your name or home address
* No longer pay sufficient tax on your income and/or capital gains.
If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to
you, you must include all your Gift Aid donations on your Self Assessment tax return or ask HM Revenue
and Customs to adjust your tax code.