CUCKFIELD MUSEUM Queen’s Hall, High Street CUCKFIELD West Sussex RH17 5EL

 Telephone No. 01444 473630

     

ENTERPRISE PATRONS’ MEMBERSHIP FORM

(please complete and send to Membership Secretary at the Museum)    Name……………………………………………. (Please Print Clearly).

Address………………………………………………………………………………………………

……………………………………………………….. Post Code ………………………………..  

   

Telephone Number …………………………. Email address ……………………………….  

       

It would be of great benefit to the Cuckfield Museum Trust (Registered Charity No. 1 1 8 2 6 0 4 ) if you could complete the following GIFT AID DECLARATION  

I am a UK tax payer and want the Charity to treat all subscriptions as Gift Aid donations from the date of this Declaration until I notify you otherwise.

 

   

Signature __________________________________________Date__________________  If possible please use the Standing Order form for payment of your subscription. Enterprise Patron £50 minimum Other (including donation) ….. Paying by standing order simplifies the administration and helps to reduce costs. Please tick this box if paying by Standing Order  

The information contained on this form will be kept safe by The Cuckfield Museum CIO (Charitable Incorporated Organisation) and will not be used for any purpose other than the CIO’s normal business.

                           

The Cuckfield Museum CIO Registered Charity No. 1 1 8 2 6 0 4