Student Membership Terms: £10 / 12 Months First Name:* First Name Required Last Name:* Last Name Required Title: Title is not valid Address line 1:* Address line 1 is Required Address line 2: Address line 2 is not valid Address line 3: Address line 3 is not valid City:* City is Required County: County is not valid Postcode:* Postcode is Required Country: Country is not valid Phone number (landline): Phone number (landline) is not valid Phone number (mobile): Phone number (mobile) is not valid Gift Aid declaration - please note that by completing this Gift Aid Declaration, the Bristol Civic Society can substantially increase the value of your subscription at no additional cost to you. By selecting “Yes” to the Gift Aid question (below) you are, in effect declaring: “I would like Bristol Civic Society to treat all donations I have made in the last four years and until further notice as Gift Aid donations. My annual income tax and/or capital gains tax is at least equal to the amount of tax that all organisations I support will reclaim in the appropriate tax year – currently 25p for every £1. I understand that other taxes such as VAT and council tax do not qualify:* Gift Aid declaration - please note that by completing this Gift Aid Declaration, the Bristol Civic Society can substantially increase the value of your subscription at no additional cost to you. By selecting “Yes” to the Gift Aid question (below) you are, in effect declaring: “I would like Bristol Civic Society to treat all donations I have made in the last four years and until further notice as Gift Aid donations. My annual income tax and/or capital gains tax is at least equal to the amount of tax that all organisations I support will reclaim in the appropriate tax year – currently 25p for every £1. I understand that other taxes such as VAT and council tax do not qualify is Required Yes No Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn't Match Lloyds Bank No val Please fix the errors above