Membership Application Form

Lower Bosmere Mill Lock (now Creeting Lock) c1910

Membership Application Form part 2I am a UK taxpayer and ask that this and any future donations Imake be treated as a Gift Aid donation for the Trust to recoverthe tax I have paid. Please tick if appropriate

Signed Date

Please complete the following details in BLOCK CAPITALS

Title (Mr/Mrs/Sir etc) Surname

First Names

Address

Post Town Post Code

Telephone Email

Nominated second voting member (family membership only)(To be eligible to vote this person must live at the same addressand be over 18)

Title Surname

First Names

STANDING ORDER

Your Bank Name

Address

Sort Code:

Account Number

Your Full Name (Block Capitals)

Your Address:

Please pay to:Co-operative Bank, PO Box 250, Delft House, Skelmersdale, WN8 6WT. Sort Code 08-92-99 Account No. 65240627

The River Gipping Trust Ltd. the sum of: £

on the 1st of (month) (year)

and the same sum on the same day each year until further notice.

Signed: Date:The River Gipping Trust Limited is a company limited by guarantee

Registered in England No. 6145692 Registered as a Charity No. 1119586

The River Gipping - your historic waterway through Suffolk

JOIN US NOW AND HELP TO RESTORE AND CARE FOR

THIS HISTORIC VALLEY

The River Gipping Trust is preserving the historic heritage of the Stowmarket Navigation by restoring the

structures that enabled navigation of the River Gipping from the docks in Ipswich to Stowmarket and caring for the

flora and fauna of the Gipping Valley

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