City of Birmingham Choir

Associate Membership /
Patronage Application Form

Title: ........

Name: ...............................................

(Joint member: ......................................)

Address .............................................

.....................................................

............................. Postcode: .............



Associate Membership (Minimum £30): £................

Patronage            (Minimum £70): £................



Gift Aid Declaration:

I want the City of Birmingham Choir* to treat as a Gift
Aid Donation all my Associate Member / Patron subscription
payments (£ ......) I make from the date of this declaration
until I notify otherwise.


Signed ...................... Date ..................



*The City of Birmingham Choir is a registered charity
(No. 1049684).

Please send this completed form, with a cheque as appropriate to: Alison Price, Associate Membership Secretary, City of Birmingham Choir, 43 Deanshill Close, Stafford, ST16 1BW.