Temporary Membership Form

Membership Application

Membership Application

First, please indicate if this is a new application or renewal and then select your required membership option - Annual or Lifetime.

Annual Options
If you select 'Yes', your card will be charged automatically every year so you will not need to renew your membership. You can cancel your membership at any time by emailing membership@holstvictorianhouse.org.uk
Lifetime Options
Name
Name
First
Last
Second person's name for Joint Membership
Second person's name for Joint Membership
First
Last
Please repeat your email address
If yes, please complete the address information below.
Address
Address
Town/City
County/District
Postcode
Country

Gift Aid

If you are a UK taxpayer you can Gift Aid your donation.  If you do this, The Holst victorian House can claim £0.25 for every £1.00 you donate at no cost to you*.

By selecting 'Yes' to Gift Aid you confirm you want to Gift Aid your donation, plus any other donations you make in the future or and that you have made in the past four years to the Holst Birthplace Trust.  You confirm that you are a UK taxpayer and that if you pay less Income or Capital Gains Tax* in the current tax year than the amount of Gift Aid claimed on all your donations, it is your responsibility to pay and difference.

* other taxes such as Council Tax and VAT do not apply.

Select Yes to receive emails with news about Holst Victorian House.

Your name and email address will be submitted to Mailchimp which is used to send out our newsletters and information emails. Mailchimp will send you a confirmation email and you MUST click on the link in this email to confirm you wish to receive these emails.

Total to pay

Credit or debit card