LINCOLN CITY SUPPORTERS TRUST
GOLD MEMBERSHIP APPLICATION
Please complete the membership details section below.
1. You can either pay £1,200 in full for the five year membership or pay a deposit of £240.00 followed immediately by 48 monthly instalments of £21.00 and then the fifth year of membership is free of payment. The extra amount payable by instalments is to cover the administration and bank charges.
2. If paying by instalments please also complete the standing order instruction on the second page below, by adding your bank account details, signature and date.
3. Return these forms, together with a cheque made payable to Lincoln City Supporters’ Trust, for either £240 or £1,200, to Membership Secretary, Lincoln City Supporters' Trust,, C/o Lincoln City F.C., Sincil Bank Stadium, Lincoln, LN5 8LD.
MEMBERSHIP DETAILS:
NAME: ……………………………………………………………………………………….
ADDRESS: …………………………………………………………………………………..
…………………………………………………………………………………..
POST CODE ………………………………
TEL NO (HOME)…………………………….. MOBILE …………………………..
E-MAIL …………………………………………………………
The data controller is Lincoln City Supporters Society Ltd. The information you give us will be held by us for the purpose of record keeping, membership matters including renewals, and direct marketing. Information is only shared with Lincoln City Football Club and Lincoln and District Football Supporters Club.
If you DO NOT want your information to be shared with Lincoln City Football Club and Lincoln and District Football Supporters Club, please mark in this box. [ ]
If you DO NOT want your information to be used for direct marketing purposes, please mark in this box. [ ]
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STANDING ORDER INSTRUCTION:
PLEASE MAKE THE FOLLOWING PAYMENT ON MY BEHALF:-
PAYMENT TO: LINCOLN CITY SUPPORTERS TRUST
BANK LLOYDS TSB, CASTLEGATE, NEWARK
SORT CODE 30-95-88
ACCOUNT NO. 00526560
PAYMENT FROM: ACCOUNT NAME ……………………………………………………
ACCOUNT NUMBER ……………………………………………………
BANK ……………………………………………………
BRANCH ADDRESS ……………………………………………………
SORT CODE ……………………………………………………
INSTRUCTION:
PLEASE PAY TO LINCOLN CITY SUPPORTERS TRUST, £21.00 ON THE 5TH MONTHLY, FOR 48 MONTHS, COMMENCING IMMEDIATELY.
SIGNATURE: ………………………………………………… DATE: ….………………………..
TRUST USE ONLY – RECEIVING BANK PLEASE QUOTE PAYMENT REFERENCE:
