BLACKPOOL CIVIC TRUST MEMBERSHIP/RENEWAL FORM 2018

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Presentation transcript:

BLACKPOOL CIVIC TRUST MEMBERSHIP/RENEWAL FORM 2018 Payment Methods Standing Order BACS Cheque Cash Membership Officer Mrs Sharon Sanderson -Roberts 307 Hawes Side Lane Blackpool FY4 5AQ Email:secretaryblackpoolcivictrust @hotmail.com Tel: 01253 315162 I wish to become an individual member £10 I wish to become a corporate member £30 I wish to renew my individual membership I wish to renew my corporate membership In all cases this completed form must be sent to the Membership Secretary at the address shown. Cheques should be made payable to ‘Blackpool Civic Trust’ If paying by post please enclose an sae. Gift Aid Declaration I wish to make a Gift Aid Declaration. From the date of this declaration until I notify you otherwise please treat all subscriptions and donations as Gift Aid donations. I understand that I must be paying an amount of tax equal to the tax the Trust reclaims on my contributions Signature:…………………………………………………… Date:………………………………………………………………. Name:………………………………………………………… Address:…………………………………………………….. ………………………………………………………………….. Post code:……………… Tel:............................ Email:………………………………………………………… Signature:…………………………………………… Date:………………………………………………… Corporate Members only Name of Company:……………………………………………………….. Company Website:………………………………………. STANDING ORDER MANDATE Please complete the form below To ……………………………….….. Bank plc ……………………………………..… Branch Please pay: BARCLAYS Bank plc Cleveleys Branch Sort Code: 20-10-03 Account: 30189626 Blackpool Civic Trust the sum of: £ …………….. Start date : ……. / ……. /……….…. and thereafter on the 1st April in each subsequent year until advised otherwise. Frequency: Annually Debit my Account: Account Name: …………………….…………..……… Account Number: ……………………………………… Please cancel any previous Standing Order in favour of the Blackpool Civic Trust. Signed: …………………………………………………… Date …….. / …..…. / ………... Please Note: The membership data is held on computer and in paper form. You are agreeing to us using your personal information for direct marketing purposes. We may use your personal information to send you promotional information about third parties which we think you may find interesting. We will not disclose or share your personal information to third parties unless we are required by law to do so. You may change you mind about us holding your data at any time by writing to or emailing us. You may request details of personal information which we hold about you under the Data Protection Act 1998 by writing to or emailing us.