Membership Form 2012
Green Economics Institute Membership Fee_____________
Membership fee ? 60 $ 130 ?72
Membership fee ? $ ?
Optional donation ? $ ?
Total: ? $ ?
Method of payment (please delete those not appropriate)
Cheque YES / NO
Bank Transfer YES / NO
Standing order YES / NO
For information about how to pay please read the following page entitled Membership Payment Options
Gift Aid Declaration (please fill in just for UK citizens)
If you are a UK taxpayer, completing this Gift Aid declaration will enable The Green Economics Institute to reclaim basic rate tax paid on your gift, increasing its total value by over 25%, at no extra cost to you. Full name_____________________
Please treat all donations I have made to The Green Economics Institute from the date of this declaration until I notify you otherwise, as Gift Aid donations.
This applies if you have paid an amount of Income or Capital Gains Tax that equals or exceeds the amount of tax to be reclaimed. Please inform us should you no longer pay UK Income Tax at any time after the date
of this declaration.
Membership payment options______________________________
If you are in the UK, payment is possible by cheque, standing order or bank transfer.
CHEQUES should be made payable to Green Economics Institute and addressed to The Membership
Secretary, The Green Economics Institute, 6 Strachey Close, Tidmarsh, Reading RG8 8EP
BANK TRANSFER FROM THE UK
A/C 20078498 Code: 16-58-10
Please use your name as the reference for this transaction so that we know who the money has come from!
BY PAYPAL – if you would like to pay by PayPal, please, send us an inquiry at email@example.com and we will send you invoice through PayPal.
STANDING ORDERS – please complete the standing order form below and return it to your bank. Our bank
details can be found just above. Please use your name as the reference for this transaction so that we know
who the money has come from!
If you are not in the UK, payment by bank transfer is usually the preferred option, however please
contact us if you have any queries about this.
Name: Green Economics Limited
Bank: Barclays Bank PLC, Bracknell Area, Berkshire, RG12
IBAN: GB28 BARC 2011 7463 4269 63
SWIFT: BIC BARCGB22
Standing Order Form (UK only)
Our details________________________________________________________ Payee name: Green Economics Institute Payee Sort code: 16-58-10 Triodos Bank Payee Account No: 20022190 Payee Ref. (your name):
Account Sort code:
Address of Bank:
I wish to pay GBP on / / and every quarter / six months / year (delete as appropriate) thereafter. Debit my account accordingly until cancelled in writing. Signature(s): Date: