BSHP - British Society for the History of Pharmacy

Application Form

Name:

Prefix	First Name	Surname	Designations

Address:

Post Code:

Telephone:

Email:

Special Interests

GIFT AID (optional)
BSHP Membership costs £30.00 per annum, if you are a UK tax payer and complete the information below the BSHP can reclaim the tax you have paid on your subscription.

GIFT AID DECLARATION (UK only) - for past, present and future donations.

Please treat as a Gift Aid Donations (please tick all boxed you wish to apply)
All qualifying gifts of money made today
In the past 4 years
In the future
I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 28p of tax on every £1 that I gave up to 5 April 2008 and will reclaim 25p of tax on every £1 that I give on or after 6 April 2008.

Please notify BSHP if you:
a) Want to cancel this declaration
b) Change your name or home address
c) No longer pay sufficient tax on your income and/or capital gains.

Signature

Download the Application Form, and return it with your payment.

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Download the Application Form
Complete your details and send the form to the address given.