Joining the Lignum Vitae Club is simple; please fill in the Lignum Vitae Club
Membership Application form below and send it to the address given.

To: The Secretary

The Lignum Vitae Club
c/o The Jamaican High Commission
1-2 Prince Consort Road
London SW7 2BZ
UK

Full Name
Address
Postcode
Telephone
Email Id

•	I/We, the undersigned, hereby apply to become a member of The Lignum Vitae Club
•	I/We accept that my/our name and address will be held on a database for use by The Lignum Vitae Club only.
•	I/We, have read and understood the brief particulars
•	I/We enclose a duly completed Direct Debit Mandate /Gift Aid form

Date
Profession
Age range

Signature ……………………………….. Date ………………………

•	The Lignum Vitae Club is a company limited by guarantee and not having a share capital. It is registered as a charity with the Charity Commission.
•	Its objectives {for the full terms of which reference should be made to its Memorandum of Association) are in any part of the World to develop a network of Jamaican Women that engages supports and achieve the best outcome for its members, enabling them to contribute to humanitarian and charitable causes, locally and globally.
•	Any woman of Jamaican heritage/wife of Jamaican may become a member of the Club on her application being accepted by the Board and shall pay an annual subscription fixed by the Board. The Subscription presently payable by individuals is £10.00 monthly or £120 annually. Concessions available on application.
•	The Board has the power to terminate Membership
•	The Board has the power to terminate Membership
•	All members have the right to vote at Annual General Meetings of the Club but such rights are lost in the case of Members whose subscriptions are in arrears
•	In the event of the Club being wound up or dissolved, its surplus assets, after discharging its liabilities, shall be given to some other charitable institution/ institutions having similar objectives to those of the Club.
•	The liability of the Members of the Club is limited. In the event that it is would up, every member undertakes to contribute to the assets of the Society a sum not exceeding £5.00
•	The management of the Club is vested in the Board

To: The Manager

Name
Branch
Bank/Building Society
Address
Bank/Building Society
Name Account Holder
Address
Postcode
Name of Current Account
Sort Code
Account No

Please make monthly Direct Debit Payments of

on ……of each month .from my account details above to:

LIGNUM VITAE CLUB
Lloyds TSB, Islington Branch, 19 -20 Upper Street, Islington London N1 0PJ

Sort Code 30 94 57

Account No 00588063

I will inform the bank in writing if I wish to cancel this instruction.

Signature ……………………………….. Date ………………………

Name & title
Address
Post Code

I would like the charity to treat

The enclosed donation of

The donation(s) of £ …..that I made on____/ /

Date:

All donations I made from the date of this declaration until I notify you otherwise

All donations I made since 6 April 20.... and all donations I make from the date of this declaration until I notify you otherwise

as GIFT AID donation.

Delete as appropriate

Signature..................

Date...............

NOTES

1	You can cancel this declaration at any time by notifying the charity. If you do so, you must pay an amount of income tax and/or capital gains tax at least equal to the tax that the charity reclaims on your donation in the tax year (currently 28p for every £1 you give).
2.	If in the future your circumstances change and you no longer pay tax on your income and capital gains equal to the tax that the charity reclaim, you can cancel your declaration
3.	If you pay tax at the higher rate you can claim further tax relief in your Self Assessment tax return.
4.	4. If you are unsure whether your donations qualify for Gift Aid tax relief, as the charity, or ask your local tax office leaflet IR113 Gift Aid
5.	5. Please notify the charity if you change your name or address