Cornwall Heritage Trust | Making the past part of our future

Cornwall Heritage Trust Membership Application Form

Twelve Month Membership:

Single £15
Family £25
Senior Citizen £10

Junior £5
Life Membership £250

Please send to: 

Mrs S Marriott, Cornwall Heritage Trust, Admin Office,
16 Trewithan Parc, Lostwithiel, Cornwall  PL22 0BD

Payment

(Please print this form.)

I enclose a cheque for £ ……………….. made payable to Cornwall Heritage Trust

Name	:
Address	:
Post Code	:
Telephone No.	:

Gift Aid

Please tick this box if you are happy for us to claim Gift Aid on your contribution – at no extra cost to you. This means that for every £1 we receive we can claim 28p from Inland Revenue providing you are a tax payer and tax equal to the tax reclaimed.

Instruction to your Bank or Building Society to pay by Banker’s Order

To The Manager
Please pay annually to Cornwall Heritage Trust
Name and full postal address of your Bank or Building Society

Bank/ Building Soc	:
Address (incl Post Code)	:
Account No:	:
Sort Code:	:
Signature:	:
Date:	:

Cornwall Heritage Trust (for official use only)

Sort Code:                 
Account No: