(Please print out and return by post or fax*)
| Name: | .......................................................................... |
| Address: | .......................................................................... .......................................................................... .......................................................................... .......................................................................... |
| Telephone No. | .......................................................................... |
| Fax No. | .......................................................................... |
| Category | Annual/Life (please
indicate) For Life Membership- Amount enclosed £200/$400. For Annual - Amount enclosed £27.50/$55. |
| Name
& Address of Bank: |
.......................................................................... .......................................................................... .......................................................................... .......................................................................... |
| Account Number: | .......................................................................... |
Please pay to The Friends of The Fan Museum at National Westminster Bank, 2 Greenwich Church Street, London SE10; account #33576475; sort code 60-09-16; today and on 1st March each successive year, until further notice, the sum of £25.00.
| I confirm that I am a UK tax payer and that I wish the Friends of the Fan Museum to treat this and all donations I make on or after this date as Gift Aid donations until I notify the friends of The Fan Museum otherwise. | |
| Signed: | .......................................................................... |
| Date: | .................................... |
| Name (in capitals) | .......................................................................... |
| Address: | .......................................................................... .......................................................................... .......................................................................... .......................................................................... |
Please return this form and cheque (if applicable) to The Membership Secretary, Friends of The Fan Museum, 12 Crooms Hill, Greenwich, London SE10 8ER. (Tel: 0208 305 1441. Fax: 0208 293 1889).
The Friends of The Fan Museum Registered charity No: 800 604