Friend Of Chichester Cinema Application Form

Charity No. 1099780

Name/s

Address

Town

County / Postcode

Telephone / Email

Credit Card No:

Expiry Date:

Start Date/Issue No. (Switch Only)

1 Person (£25) ___ tick for single membership

2 People (£45) ___ tick for joint membership

OR: Please make cheques payable to: Chichester Cinema at New Park

Signature:

Date: (as cheque)

Gift Aid Declaration Form

I wish the Chichester Cinema to reclaim tax on my subscriptions and donations from today's date until I notify the cinema otherwise.

I am / am not a UK taxpayer.

Name/s

Address

Town

County / Postcode

Telephone

Signature:

Date:

Post to:FRIENDS, Chichester Cinema, New Park Road, Chichester, PO19 7XY.

Name/s
Address
Town
County / Postcode
Telephone / Email
Credit Card No:
Expiry Date:
Start Date/Issue No. (Switch Only)
1 Person (£25)	___ tick for single membership
2 People (£45)	___ tick for joint membership
OR: Please make cheques payable to: Chichester Cinema at New Park
Signature:
Date: (as cheque)

Gift Aid Declaration Form
I wish the Chichester Cinema to reclaim tax on my subscriptions and donations from today's date until I notify the cinema otherwise. I am / am not a UK taxpayer.
Name/s
Address
Town
County / Postcode
Telephone
Signature:
Date: