Yes, I would like to become a Silver member of the
Please send completed forms with remittance to: - Membership Secretary, Lincoln City Supporters Trust, Sincil Bank Stadium,
ADDRESS: ………………………………………………………………………………….
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POST CODE ………………………………TEL NO ……………………………………. …
Date of Birth ………………. E-
Please send me information, newsletters and marketing communications by email.
ANNUAL SUBSCRIPTION - £100.00 which includes £50.00 worth of shares and many exciting benefits
I enclose a cheque/postal order for £100.00 made out to Lincoln City Supporters Trust
Alternatively payment can be made by credit card
MASTERCARD [ ] VISA [ ] DELTA [ ] EXPIRY DATE: ……………………..
SWITCH/MAESTRO ISSUE NO ………………………………….
START DATE (if applicable) ……………..…. EXPIRY DATE …………………………….
NAME ON
ACCOUNT NO: …………………………………………………………………………….
I agree to abide by the Rules of the Society
SIGNED: …………………………………………………………………………….
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
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. [ ]
STANDING ORDER
To: -
The Manager
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Please pay to Co-operative Bank Plc, P O Box 250, Delf House, Southway, Skelmersdale, WN8 6WT, Sorting Code 08-92-99 for the credit of Lincoln City Supporters Trust, account number 65063215 as follows: -
Usual amount of payment: £100.00
Amount of payment in words: One hundred pounds only
Frequency of payment: ANNUALLY
Date of Payment: 1st July
Date of First payment: Immediately
Date of final payment: Until further notice
Please quote reference:
I/we authorise you to debit my/our account in accordance with the above-mentioned details.
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Signed
Full Name and Address of account holder.
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Account number Sorting Code
