When complete please print out,
sign and date this form and
send it to:

Mrs G Gage
Membership Secretary
Lincoln Music & Drama Festival
15 Somerville Close,
Waddington,
Lincoln. LN5 9QP
Request to become a Patron

Your Details
TitleForename(s)Surname
Full Home Address
Postcode
Email address
Telephone number

PATRON:           Single …… @ £13.50 minimum £……… Double …… @ £20 minimum £…………

(Please make cheques payable to: Lincoln Music and Drama Festival)

If you would like the Festival as a Charity (Reg. Charity No. 509415)
to treat this and any donations as Gift Aid, please sign the declaration below.

Please tick all applicable selections on the left
       I would like to Gift Aid* this donation
      And  
       I would like to Gift Aid* all future donations until further notice
      And 
       I would like to Gift Aid* all donations within the charity’s current
             financial  period  and the previous 6 financial periods.
* To qualify for Gift Aid, what you pay in UK income tax or capital gains tax must at least equal the amount the charity will claim in the tax year
After completing the above sections, please print the form, sign and date it.
SignatureDate