Your name: / ......
Your address: / ......
......
...... Your post code:......
Telephone no: / ......
Email address: / ......
Please complete email address: paper copies of the programme will still be sent out, unless you specify otherwise, but this information helps us to advertise last minute events. Thank you for your help
If your mailing details are incorrect, please notify any changes, using this form, to:
CFCSCT, 1 The Manor, Herringswell, Bury St Edmunds, Suffolk IP28 6SH
TICKETS ARE NON REFUNDABLE,(except in the case of cancellation)
BUT CAN BE TRANSFERRED
EVENT / 2018 / PRICE / No / TOTAL
Visit to The Museum of Cambridge / Thu 11 Jan / £15.00 / £
Tea Party – Lady Gershon / Wed 31 Jan / £13.00 / £
Opera Evening / Fri 2 Feb / £27.00 / £
The Cambridge Ceremonial Year / Wed 7 Feb / £10.00 / £
The History of Anstey Hall / Thu 15 Feb / £15.00 / £
Henslow of Hitcham / Thu 1 Mar / £10.00 / £
A Conductor’s Experience / Wed 7 Mar / £15.00 / £
Quiz Evening / Fri 9 Mar / Please see enclosed booking form
Tea Party – The Doctor and Medical Teacher / Tue 13 Mar / £13.00 / £
TOTAL TICKET PAYMENTS / £
TOTAL DONATIONS (SEE GIFT AID FORM OVERLEAF) / £
GRAND TOTAL (TICKETS AND DONATIONS) / £
  1. Complete the form & send a single cheque to cover all your tickets and/or donations
  2. Make your cheque payable to CFCSCT(Please note: we are unable to accept CAF cheques as payment for tickets)
  3. Enclose a stamped, self-addressed envelope with your application form & cheque
  4. Send to: CFCSCT, 1 The Manor, Herringswell, Bury St Edmunds, Suffolk IP28 6SH

FURTHER IMPORTANT INFORMATION OVERLEAF

...... PTO......

BECOME A FRIEND OR MAKE A DONATION
I / We wish to make a single donation of: / £
I / We wish to use this donation to become Friend(s) of Acorn House
(minimum £20 per household per annum) / Yes / No
(please circle)
CAN YOU HELP?
I am interested in helping at talks & luncheons
I am interested in helping with collections & at outdoor events
I would like to donate a Tombola / raffle prize /
/ (Please tick)
GIFT AID
If you are a UK taxpayer, using Gift Aid allows The Sick Children’s Trust to reclaim an additional 25p for each £1 donated. Read the declaration below (or go to charities section of the HMRC website - please then sign & enter the date to allow us to claim Gift Aid on your donation.
I am a UK taxpayer and would like the CFCSCT to treat as Gift Aid all donations I have made for this tax year, for the six years prior to this declaration and all donations I make from the date of this declaration until I notify you otherwise.
Signed ………………………………...... Date ……………………………………..
STANDING ORDERS
If you would prefer to make regular donations to The Sick Children’s Trust by standing order, please complete the details below.
Please pay the sum of £ …...... ……. to The Sick Children’s Trust at the Royal Bank of Scotland plc, 82-88 Hills Road, Cambridge, CB2 1LG. Branch sort code 16-15-19. Account number 10098835.
Please make the first payment on …………………… and (weekly / monthly / annually) thereafter
Account name …………………………………......
Account number …………………………...... Sort code …... - …... - …...
Bank name and address ……………………………………......
Signature ...... Date ......
If you have friends who wish to be added to our mailing list, please enclosetheir name, address, post code and telephone number on a separate page.
If you wish to SPONSOR THE WORK OF THE CHARITY (e.g. by providing postage, venue costs, poster displays, wine for events etc) contact Patsy Glazebrook 01799 541180
If you would like to receive your programme by email ONLY please enter your email address on the previous page and tick this box:
If you no longer wish to receive our programme, tick this box:
You must enter your name & address overleaf or we will not
have any means of identifying you to remove your details /

CFCSCT use only: Donor acknowledged O SO to bank O SO recorded O GA recorded O