UrbanDesignGroup

MembershipApplicationForm

Please complete details below clearly in block capitals.

Name: / How to pay
  • By cheque (made payable toUrban Design Group and sent to the address below).
  • Online by PayPal (
  • Direct Debit (see below).
  • Invoice – please provide full details including address (in billing address box) and purchase order number.

Address including post code:
(for correspondence & delivery of Urban Design)
Return your completed application to:
Urban Design Group
70 Cowcross Street, London,EC1M 6EJ
Tel: 020 7250 0892
Email:
Signed: ______
Date: ______
Mobile/tel. no.:
Email:
Billing address (if different):
Please tick here if you require an invoice 
Purchase order number:______
Invoice contact:______/ Gift Aid Declaration Make your payment to the UDG worth 28% more
As a registered charity, the UDG can reclaim tax on your annual subscription fee through theGift Aid scheme.
Providing you pay an amount of Income Tax and/or Capital Gains Tax at least equal to the tax that the charity reclaims on your donations in the appropriate tax year (currently 28p for each £1 you give), your annual payment will be eligible as Gift Aid.
Please sign the declaration below if you are aUKtaxpayer. It will not cost you anything, but will be of great benefit to the UDG.
I wish the Urban Design Group to treat as Gift Aid all membership subscriptions I will pay on or after the dateof this declaration.
Signed: ______Date: ______
How did you hear about the Urban Design Group?
Please tick appropriate membership category:
Individual (UK/ International) £50 /  / University £250 / 
Concession £30 /  / Small Practice £250 
UK Library £80 /  / Large Practice £450 / 
International Library £100 /  / Recognised Practitioner
Local Authority£100 /  / £80 – Please see website
for additional forms.
URBAN DESIGN GROUP / Instruction to your Bank or Building Society
to pay by Direct Debit /
Please fill in the whole form including official use box using a ball point pen & send it to:
Urban Design Group
70 Cowcross Street
London EC1M 6EJ
Name (s) of Account holder (s)
Bank/Building Society Account Number
Branch Sort Code
Name & full postal address of your Bank or Building Society
To: The Manager Bank/Building Society
Address:
Postcode:
Reference
/ Service User Number
For PSL reUrban Design Group OFFICIAL USE ONLY
This is not part of the instruction to your Bank or Building Society.
Important – Please complete these details
Account Holder (s) Name & Address
Name:
Address:
Postcode:
Email address:
Instruction to your Bank or Building Society
Please pay PSL reUrban Design Group Direct debits from the account detailed in this instruction subject to the safeguards assured by the Direct debit Guarantee. I understand that this instruction may remain with PSL re Urban Design Group and, if so, details will be passed electronically to my bank/building society.
Signature (s):
Date:
Banks & Building societies may not accept Direct debit Instructions for certain types of accounts.