1. 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
secretaryblackpoolcivictrust
@hotmail.com
Tel:
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:
…………………………………………………………
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:
Account: 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 ing us. You may request details of personal information which we hold about you under the Data Protection Act 1998 by writing to or ing us.