FELLOWSHIP APPLICATION FORM

Please complete this form and send to:

The Director, Royal Asiatic Society, 14 Stephenson Way, London, NW1 2HD, United Kingdom
or e-mail to info@royalasiaticsociety.org

Title:………………..Forename(s)…………………………………………………………………………………………

Surname……………………………………………………………………………………………………………………

Occupation………………………………………Date of Birth…………………………………………………………...

Address…………………………………………………………………………………………………………………….

Postcode……………………………………………Country……………………………………………………………...

E-mail…………………………………… ………………………………………………………………………………...

Daytime Telephone Number……………………………………………………………………………………………….

My area of interest is:

Tick
□ I would like my name and contact details to be included in the fellows list in printed form and/or online

Signed……………………………………………………………………………………………………………………...

Date………………………………………………………………………………………………………………………...
 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 and send
it to: Service User Number (SUN)

Royal Asiatic Society 8 3 9 4 3 7

14 Stephenson Way
London NW1 2HD
FOR Royal Asiatic Society OFFICIAL USE ONLY
Types of Fellowship (please tick the box that applies to you): This is not part of the instruction to your Bank or Building Society.
Important – Please complete these details:
□ Full UK (£60) □ Overseas South Asia(£30)
□ Overseas (£40) □ Student Fellow (£20) Account Holder(s) Name & Address:
□ Affiliated Fellow (£20)
Name:
Name(s) of Account Holder(s)

Address:

Postcode:
Bank/Building Society account number

Email Address:

Branch Sort Code Instruction to your bank or building society

Name and full postal address of your Bank or Building Society
To: The Manager
Please pay Royal Asiatic Society 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 Royal Asiatic Society and, if so, details will be
Bank/Building Society passed electronically to my bank/building society.

Address Signature(s)

Postcode Date

Reference Number

DDI1
Banks and Building Societies may not accept Direct Debit Instructions for some types of account

This guarantee should be detached and retained by the Payer.

The
Direct Debit
Guarantee
• This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits.
• If there are any changes to the amount, date or frequency of your Direct Debit Royal Asiatic Society will notify you 5 working
days in advance of your account being debited or as otherwise agreed. If you request Royal Asiatic Society to collect a
payment, confirmation of the amount and date will be given to you at the time of the request.
• If an error is made in the payment of your Direct Debit, by Royal Asiatic Society or your bank or building Society, you are
entitled to a full and immediate refund of the amount paid from your bank or building society
- If you receive a refund you are not entitled to, you must pay it back when Royal Asiatic Society asks you to
• You can cancel a Direct Debit at any time by simply contacting your bank or building Society. Written confirmation may be
required. Please also notify us.
All Fellows who are UK taxpayers are requested to complete this form and return it
to The Royal Asiatic Society, 14 Stephenson Way, London NW1 2HD so that the
Society can get the maximum benefit under the rules for charitable giving.
……………………………………………………………………………………….
GIFT AID DECLARATION
Name of Charity: …………………………………………………………………….
Amount: ……………………………………………………………………………..

I wish the Royal Asiatic Society (Registered Charity No. 209629) to treat all donations
(which shall include subscriptions) I have made in the past 4 years, and all donations
(which shall include subscriptions) I make from the date of this declaration until
further notice as Gift Aid Donations. You must pay an amount of Income Tax
and/or Capital Gains Tax for each tax year (6 April one year to 5 April the
next) that is at least equal to the amount of tax that all charities you donate to
will reclaim on your gifts for that tax year. Council tax and VAT do not count.

Signed:………………………………………………………………………………..

FULL NAME (Please print):………………………………………………………….

ADDRESS:…………………………………………………………………………..

……………………………………………………………………………………….

POSTCODE…………………………………………………………………………

DATE:………………………………………………………………………………..

Please notify the charity if you:

1. Want to cancel this declaration.
2. Change your name or home address.
3. No longer pay sufficient tax on your income and /or capital gains.

Tax claimed by the charity

The charity will reclaim 28p of tax on every £1 you gave up to 5 April 2008.
The charity will reclaim 25p of tax on every £1 you give on or after 6 April 2008.

If you pay income tax at the higher or additional rate, you must include all your Gift
Aid donations on your Self Assessment tax return if you want to receive the additional
tax relief due to you.