Membership – Hindu Samaj Swindon

HSS - Membership Application Form

Personal Details

Title*

First Name*

Last Name*

Spouse/Partner Name

Children *

Children Ages *

Current Address

House Number/Name*

Street*

Area

City/Town*

Post Code*

Home Telephone

Mobile Telephone*

Email Address*

Applicant Declaration & Data Consent

The information you have provided in this form will be used to process your application. It will not be passed to third parties or used for other purposes. Security procedures are in place for protecting your data in accordance with the principles contained in the General Data Protection Regulations 2018. Your details may be stored electronically in a password protected system and/or as paper copies in a secure cabinet. Please read the statements below and then sign and date to confirm your acceptance of them.* You also consent us to claim the gift aid on this payment.*

Payment

£25 - Couple or Family | £15 - Single

Payment Offline Payment Online

Please make appropriate membership payment into the following Bank Account before submitting the form and acknowledge accordingly:

Bank:Lloyds
A/c Name: Hindu Samaj Swindon
Sort Code: 30-99-50
A/c no.: 21752163

PLEASE QUOTE "HSS Membership"

Please confirm you have paid*
Yes No
Please select which amount you have paid*
£25 £15
What name will appear on our bank statement?*