Application for Membership 2017/18

Application for Membership 2017/18

Surname / Forename
Position / Nature of Business
Business Name: / Telephone Number
Business Address: / Fax Number
Email
Website
Number of Employees
Date of Application
Please briefly describe your business:

Annual Fees

Full Membership - Businesses based in or supplying products and services to Peacehaven and surrounding area. Joining between (Please tick appropriate box):

1 Feb 2017 to 31 January 2018 - £85.00 / 1 Aug 2017 to 31 Jan 2018- £42.50

Affiliate Membership – Voluntary Organisations, Not-for-profit sector, Charities, Schools & Colleges, Social Enterprises. Joining between (please tick appropriate box)

1 Feb 2017 to 31 January 2018 - £42.00 / 1 Aug 2017 to 31 Jan 2018 - £21.00

Payment Options

Option 1 – full payment by cheque

Please make cheques payable to PEACEHAVEN CHAMBER OF COMMERCE for the relevant fee and return with this form to: Peacehaven & District Chamber of Commerce, C/O Jarlands, 187a South Coast Road, Peacehaven BN10 8NS

Option 2 – full payment via on-line banking.

The details you will need are as follows:

Bank: Barclays plc

Sort Code: 20-49-76

Account No: 50867470

Please ensure your business name is used as the reference to identify your payment

For either Option 1 or Option 2, attendance at the Breakfast Club will require payment of £10.00 each time you attend. You will be asked to book in advance in the usual way.

Option 3 – monthly payment via standing order.

Pay £20.00 monthly by standing order and not only is your membership paid, but any Breakfast Club Meetings you choose to attend as well! A year’s worth of free breakfasts!* Please complete the enclosed standing order form with your bank details and return to the address on the form. (*Please note Breakfast Club takes place on 1st and 3rd Tuesday of each month.)

Finally, how did you hear about us?

Mailshot / Member Referral / Newsletter / Press Article / Website

If one of our members referred you, please give us the name of that business so that we are able to thank them:

BUSINESS NAME:

Peacehaven & District Chamber of Commerce

STANDING ORDER MANDATE

To.…...... Bank Plc

Address...…......

......

...... Post Code...... …

PLEASE PAY / BANK / BRANCH TITLE (Not address) / SORTING CODE NUMBER
BARCLAYS / PEACEHAVEN / 20-49-76
FOR THE / BENEFICIARY’S NAME / ACCOUNT NUMBER
CREDIT OF / PEACEHAVEN CHAMBER OF COMMERCE / 5 / 0 / 8 / 6 / 7 / 4 / 7 / 0
THE SUM OF* / AMOUNT IN FIGURES / AMOUNT IN WORDS
£20.00 / TWENTY POUNDS
PAYMENT DATE
ON THE 1ST DAY OF EACH MONTH COMMENCING ______*
QUOTING MY REFERENCE (1)

ACCOUNT TO BE DEBITED IN THE NAME OF: ______

SIGNATURE(S) ______

ACCOUNT NUMBER SORT CODE

DATE ______

(1)  Please quote this reference on all transactions/correspondence

PLEASE RETURN TO: The Treasurer, Peacehaven Chamber of Commerce, c/o HM Bookkeeping & Payroll Services Ltd, 15 Newhaven Square, Newhaven, East Sussex, BN9 9QS

* Please insert the month of the year you wish to commence payment