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– Standing Order
( Please do not send to your bank )
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Instructions to your Bank or Building Society:-
Please make one payment now, and thereafter pay annually on 1st January to:-
The Alexandra Palace Organ Appeal, CAF Bank Ltd, 25 King’s Hill Ave., King’s Hill, West Malling, Kent, ME19 4JQ: Sort code 40-52-40 Account No 00017427 Alexandra Palace Organ Appeal.
the sum of £ 15 or …………..( Please amend if you wish to make a donation in addition to the minimum donation of £15).
Name of your Bank /Building Society ………………………………………………………….
Address of your Bank / Building Society …………………………………………………………….
………………………………………………………. Post code……………………………..
Name( s) of account holder ( s) ( Please print) ………………………………………………
Your account number …………………………………….. Sort code ………………………..
Your signature …………………………………………….. date ……………………………….
Your address ………………………………………………………………………………………
………………………………………………… Post Code ……………………………………….
Telephone number ………………… Email address ………………………………
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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 6th 2009, 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 1 Iss 6