Falklands Conservation

Membership Form

Please print out and return to:

FALKLANDS CONSERVATION
1 Princes Avenue, Finchley, London N3 2DA, United Kingdom


From: (Name)

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Address:

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_________________________________________

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Postcode:

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I/We wish become a member of Falklands Conservation as follows:*


 Individual Member £20 ($40)

Family Member £35 ($70)

Gold Member £100 ($200)

Life Member £750 ($1500)

Donation

TOTAL:

 		£/$ _________

£/$ _________

£/$ _________

£/$ _________

£/$ _________

£/$ _________
* Please enclose a cheque payable to Falklands Conservation or complete the credit card form below.

I authorise you to debit my ACCESS/VISA/MASTERCARD account with:

The amount:

 		£_________

Card Number:

 		_______________________


 Expiry Date:

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Name on Credit Card:



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 Cardholder's Signature:

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Cardholder's Address:
(if different from above)
 		_______________________

_______________________

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Gift Aid Declaration
UK Tax Payers

Please Use Gift Aid to make your membership subscription and donations worth more to us. For every pound you give us, we earn an extra 28 pence. To qualify for Gift Aid, what you pay in UK income tax must at least equal the amount we will claim in the tax year.

Sign me up for Gift Aid with Falklands Conservation:

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Signature:

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Date:

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Thank you for your support.

Falklands Conservation UK Charity 1073859
Patron: HRH The Duke of York CVO ADC
Member of the International Union for Conservation of Nature | BirdLife International Representative