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Please print out this form and mail to
JOIN
NOW

Mrs Kate Cartmell, Membership Secretary
Lytham St Annes Civic Society
51 Hall Park Drive
Lytham St Annes
FY8 4QZ

I enclose a Cheque/P.O., made out to Lytham St Annes Civic Society, for:

[.....]
£ 6 to become a Member
[.....]
£10 for Family Membership
[.....]
£25 to become a Patron
[.....]
£100 to become a Life Member
[.....]
£ ..... as a donation

Patrons support the Society by each making regular payments of £25 or more,
and are listed in our Annual Report.

NAME (BLOCK CAPITALS PLEASE)

...................................................................................................................

ADDRESS ..................................................................................................

...................................................................................................................

........................................................................POSTCODE ........................

TELEPHONE No. ...............................................................

E-MAIL ADDRESS .............................................................

If you are a taxpayer, by adding your name below you will enable us to reclaim tax from the Inland Revenue. (28p for each œ1 you give, with tax rate at 22%).

I wish the Society to treat all subscriptions and donations I make to the Society as Gift Aid from the date of this declaration until I notify you otherwise. I understand that I must be paying an amount of tax equal to the tax the Society reclaims on my contributions.

Taxpayer's name: ..................................................... Date .........................

We should be pleased too if you would consider the Society when deciding on legacies in your will.


You may find it convenient to make subscription payments by banker's order, and we should appreciate it if you would do so; it does ease administration within the Society

Standing Order Mandate

To: ........................................... Bank Plc .................................... Branch

Please pay: BARCLAYS Bank Plc, LYTHAM Branch

Sort code: 20-10-03, Account: 60614238 Lytham St Annes Civic Society

The sum of: £ ......... Start date: 1st May 20.... Frequency: Annually

Debit Account: ................................................... Number: ................................
Please cancel any previous Standing Order in favour of the Society.

Signed ................................................... Date .............................