The Bath Mozartfest is a registered charity no. 1040455

PRINTABLE MEMBERSHIP FORM

I/We wish to become a Friend / Patron / Gold Patron / Benefactor / Mozartfest Circle member of Bath Mozartfest 2005. Please tick appropriate box:
Friend: £50+ per person per annum
Patron: £250+ per person per annum
Gold Patron: £500+ per person per annum
Benefactor: £1,000+ per person per annum
Circle Member: £5,000+ per person per annum

Signature ___________________________ Expiry date: ____________

Valid from: ________     Date of Payment: _______

Security code: ______     Issue No: (Switch/Maestro cards only) ____

Please print this form and send with your payment to:

Bath Festivals Box Office
2 Church Street, Abbey Green, Bath BA1 1NL

Name ___________________________________________________

Address _________________________________________________

Post Code ______________  Tel ______________________________

Email ___________________________________________________

GIFT AID
If you are a tax payer the Bath Mozartfest, as a registered charity,
can reclaim the tax that you have paid and add it to your gift to
make every donation you send worth even more to the Festival,
at no extra cost to you. (Please tick boxes below if you are in agreement)

Please treat my donations as Gift Aid donations from the date of this
declaration until I notify you otherwise

I confirm that I currently pay an amount of income tax or capital gains
tax at least equal to the amount to be reclaimed, and I expect this
situation to continue

I understand that I am under no commitment to make any further
donations and I may cancel this declaration at any time

Data Protection Act (please tick if you are in agreement)
I would like the information above to be stored by Bath Mozartfest,
to keep me informed of the Festival's activities.

Thank you for supporting the Bath Mozartfest. Reg charity no. 0140455