BSB Membership Form
Sign up as a member to the Benevolent Society of Blues - membership costs just £15 per annum.
SURNAME *
Your answer
FIRST NAME(S) *
Your answer
MAIDEN NAME (IF APPLICABLE)
Your answer
TITLE *
Your answer
ADDRESS *
Your answer
CONTACT NUMBER *
Your answer
EMAIL ADDRESS *
Your answer
DATES AT CH *
Your answer
HOUSE/WARD/STAFF *
Your answer
DONATION AMOUNT? (Minimum membership fee is £15) *
DONATION FREQUENCY? Choose a donation option - you might want to pay annually, or spread the cost monthly, or donate a smaller amount more frequently.
HOW WOULD YOU LIKE TO MAKE YOUR DONATION? (We will send you payment details to your email address depending on your choice) *
GIFT AID? For every £1 you give, the BSB will be able to reclaim tax at the current standard rate as long you have paid, or will pay, income tax or capital gains tax at least equal to the amount reclaimed in the financial year. *
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