Print this membership form, complete the appropriate sections, and send to: Solicitors Benevolent Association, 1 Jaggard Way, Wandsworth Common, London SW12 8SG or DX 41608 Balham (cheque payable to 'Solicitors Benevolent Association'

1. Individual Membership
I wish to become a member of the SBA. (Annual Member £10 or more, Life Member £100 or £50 for those over 60 years of age)
I enclose a cheque/bankers order for £ _________
BLOCK CAPITALS PLEASE
Full name (Mr/Ms/Ms/Miss)  
Name of firm  
Address  
    Postcode  
DX No      Date admitted a Solicitor  
Signature     Date  
2. Firm’s Subscription
We wish to subscribe to the SBA and
2.1. enclose a cheque/bankers order for *£ _________ to cover the partners/assistants listed on the attached sheet. (Please specify Names, Forenames, Date of Enrolment and
whether partner or assistant.)
or
2.2. request that further details may be sent to us.
DELETE AS APPROPRIATE
Name of firm  
Address  
    Postcode  
DX No  
Town  
Signature     Date  
*Annual subscription £10 per member nominated: Life subscription £100 per member (£50 for those over 60 years of age).
Bankers Order Form (for either an individual or firm’s subscription)
To: The Manager     Bank Plc
Bank Address  
    Postcode  
Bank Sort Code  
Account No  
Account Name  

This order cancels any existing instruction given in favour of the payee
Pay to: NatWest Bank Plc, 217 Strand, London WC2R 1AL, Sort Code: 60-80-08, for Account: Solicitors Benevolent Association, Account No. 03475204
Now and hereafter annually on the _____ day of ________ the sum of £ _________
WHEN PAYING PLEASE QUOTE
Surname     Initials  
SBA Membership No. (SBA admin to complete)  

Signature     Date  
Gift Aid Declaration
I (insert full name) _______________________________wish all donations I make to the Solicitors Benevolent Association (SBA) on or after the date of this declaration to be Gift Aid donations. I pay income tax or capital gains tax at least equal to the basic rate income tax that the SBA will be able to reclaim on my donations. I understand that I will be able to claim higher rate tax relief for donations I make to the SBA set against income tax or capital gains tax. I enclose a donation of £ _________
Date ______________