Meridian Programme Associate Membership
Registration Form
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First
Name
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Last
Name
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Date
of Birth
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Address
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Address
(contd.)
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Address
(contd.) |
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City
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County/State/Province
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Postal/Zip
code
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Country
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Telephone: |
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Mobile: |
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Fax: |
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E-mail
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Web-site
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Profession
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Profession
2 (if any)
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Special
Interests (1)
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Special
Interests (2)
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Special
Interests (3)
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Financial
Contribution
Associate Membership involves a
flexible financial contribution. You
determine the actual amount by self-assessment based on a proportion of your
available income. This puts all the
power of decision-making in your own hands, whilst retaining complete
confidentiality concerning the details of your personal income. It also ensures
that financial circumstances debar no-one from becoming an Associate.
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Calculate your annual available income. [To some that may
mean "after tax and national insurance", for others "after deductions for
housing, bills etc.", and for yet others "what is left at the end of the
month". Any change in personal
circumstances is reflected in the amount of available income.]
- Determine the maximum, sustainable, proportion of available
income that you can afford to contribute to the work of the Meridian Programme
[e.g. 10%; 5%; 2%; 1%; ½%; etc.]. Any
shift in your commitment to the Programme will influence the percentage you
choose to contribute.
- Choose the most convenient payment period, i.e. monthly,
quarterly, half-yearly, or annually.
- Enter the amount of your initial contribution in
the box provided.
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Contribution
every:
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Month
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Quarter
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6Month
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Year
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First
Contribution:
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Joining Donation:
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Total
Enclosed:
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GiftAid
The Meridian Programme is hosted by the Unit for
Research into Changing Institutions (URCHIN), a UK Charitable Trust, Reg. No. 284542. For us to reclaim tax under the GiftAid
scheme you must pay an amount of income tax and/or capital gains tax at least
equal to the tax that URCHIN (Meridian) reclaims on your contributions in the
tax year (currently 28p for each £1 you give). You can cancel this declaration at any time by notifying us.
If in the future your circumstances change
and you no longer pay tax equal to the tax that we reclaim, you can cancel this
declaration. If you pay tax at a higher
rate you can claim further tax relief in your Self Assessment tax return. |
I
am a UK taxpayer
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I want all contributions/donations to be Gift Aid
until I tell you otherwise
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Data Protection:
In signing this form you agree that we can hold
in our database the details about you given above. We will take steps to protect your personal data and we will not
disclose these details to anybody without your consent. |
Signature
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Date:
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Please print this form, complete and return it with your cheque
(made payable to Meridian and drawn in sterling on a UK bank)
To:
Programme Administrator,
Meridian Programme,
Meridian House,
115 Poplar High Street,
London E14 0AE, UK
Notes:
- All cheques must
be made payable in GBP and drawn on a UK bank. Please contact the Administrator for account details if you wish to pay
by direct bank transfer.
- All Associates
from non-sterling currency areas must use the on-line Registration Form with its links to the credit card facilities managed on our
behalf by the secure servers of WorldPay.
- A Certificate of
Registration as an Associate of the Meridian Programme will be issued on
receipt of the completed registration form together with the first financial contribution
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