Membership Form

individual - £10group - £20

I would like to receive EMBRACE materials and information about events

I would like to be involved in a working group

Name of Charity: EMBRACE Charity Ref No XR 92283

Using Gift Aid means that for every pound you give, the charity you are supporting will receive an extra 28 pence from the Inland Revenue, helping your donation go further. To qualify for Gift Aid, what you pay in income tax or capital gains tax must at least equal the amount the charity will claim in the tax year. To allow EMBRACE to benefit from this support simply complete and sign the declaration below.

Please tick this box if you wish EMBRACE to treat as Gift Aid Donations all donations that you make from the date of this declaration until you notify us otherwise in writing

1. You may cancel this declaration at any time by notifying EMBRACE.
2. If in the future your circumstances change and you no longer pay tax on your income and capital
gains equal to the tax that the charity reclaims, you can cancel your declaration.
3. If you pay tax at the higher rate you can claim further tax relief in your Self Assessment tax return.
4. If you are unsure whether your donations qualify for Gift Aid tax relief, ask for advice from
EMBRACE or refer to help sheet IR65 on the HMRC website (
5. Please notify EMBRACE if you change your name or address.
6. The contact address for any correspondence is: EMBRACE, 48 Elmwood Avenue, Belfast, BT9 6AZ