patrons_logo Becoming a Patron - Sulgrave Manor by tQ7Cr31i


									Becoming a Patron
Please fill out this form and then send via post to:

                                       Sulgrave Manor
                                        Nr. Banbury
                                          OX17 2SD

Or you can email it back to us at:

Faxes are also accepted on:            01295 768056

                                  Personal Details
       I am giving £ __________ and I would like to be a: _______________

                         Bronze Patron Silver Patron Gold Patron
                         £50+ p.a.     £1000+ p.a. £10,000+ p.a.

          Title: ____                    Address: _______________________
         Name: _______________________            _______________________
         Phone: _______________                   _______________________
         Email: _______________________ Postcode: ________

                                 Payment Methods
Please tick your chosen method:

       By Electronic Transfer

        The Sulgrave Manor Board account is at :

        Barclays, Banbery
        Account No.             30854352
        Sort Code:              20-03-84

        Reference : please use your surname and the Patron level you have chosen (eg
        Taylor Gold, Smith Silver)

       By Credit or Debit Card

        Name as on card if different from above:
        Number:________________________________ Expiry
        Date:___/___ Start Date:___/___
        Security Number (Last 3 digits on signature strip):_____
        Issue No:_____
      By Standing Order

       Please fill in this form and send it to 'Patrons Guild, Sulgrave Manor,
       Sulgrave, Banbury, OX17 2SD'. We will copy it for our records and forward it
       to your bank

      Cheque

       Please make the cheque payable to The Sulgrave Manor Board send it to
       'Patrons Guild, Sulgrave Manor, Sulgrave, Banbury, OX17 2SD'.

                                      Gift Aid
Increase the value of your donation at no further cost to you. As a Patron all you have
to do is download and complete the Gift Aid declaration and the donation element of
your contribution to Sulgrave Manor will be increased significantly.

You must pay UK income tax and/or capital gains tax at least equal to the tax
Sulgrave Manor reclaims on your donations in the tax year. For Gift Aid purposes we
have to declare the commercial value of the benefits offered to Patrons. The values,
which do not qualify for Gift Aid, are £35 at Bronze, £350 at Silver, £850 at Gold.
The balance of your payment is a donation qualifying for Gift Aid.

      Gift Aid declaration (please tick)

                           US Tax Deductibility
If you wish your donation to be tax-deductible in the USA, our US Friends
organisation is registered as 501 (c) 3.

Please make your dollar check out to Friends of Sulgrave Manor B Account and send
it to the Patrons Guild, Sulgrave Manor, Sulgrave, Banbury, OX17 2SD. We will
forward it to the Friends. For electronic transfers: the bank is First Community Bank,
Harbor Springs MI 49740; the routing # is 072406771 and the account # 1140968.
Please quote your surname and the Patrons' level you have chosen (eg Taylor Gold or
Smith Silver) as a reference.

      I will be sending my donation electronically to the US Friends of Sulgrave
       Manor (please tick)

                               Data Protection
Your details will not be shared with any other organisation without your specific

      I consent to my name being included in the Patrons' newsletter (only
       accessible with password) and, if appropriate, on the Patrons' Roll of Honour

To top