Alexandra Palace Organ Appeal

Alexandra Palace, Wood Green, London N 22 4AY

Registered Charity No. 285222

Patrons: His Grace The Duke of Marlborough, Dr Roy Massey, Carl Jackson

Trustees: Graham Hawkes ( Chair), Hugh Macpherson (Secretary), Simon Gutteridge ( Treasurer)

Michael Rhodes, John Apperley, David Moores, John Pryer, Roger Tucker, Stephen Walmsley,

APPLICATION FORM TO BECOME A FRIEND 2011

Please complete the form below and send with your cheque to :-

The Treasurer, Alexandra Palace Organ Appeal,

41 Vanderbilt Road, London SW18 3BG

Or alternatively hand in at one of the concerts with cash or cheque

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I wish to join the Friends of the Alexandra Palace Organ Appeal

Your signature …………………………………………….. date ……………………………….

Your name (please print) …………………………………

Your address ………………………………………………………………………………………

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

Telephone number ………………… Email address ………………………………

The minimum annual donation is £ 15 and falls due on 1^st January each year. Cheque should be made payable to “ Alexandra Palace Organ Appeal”. Donations in addition to the minimum are welcome.

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GIFT AID Please complete the following if you would like your donation to be classed as gift aid which will enable the Alexandra Palace Organ Appeal to reclaim income tax .

I would like the amount I have given to the Alexandra Palace Organ Appeal since April 6^th 2010, and all future donations to be treated as Gift Aid donations. I can cancel this at any time by notifying the charity.

Signature…………………………………………….. Date ……………………………….

Forenames ……………………………….. Surname ……………………………………

Form 2 Iss. 6