Bollington Brass Band

Patron’s Application Form

We hope you enjoy supporting Bollington Brass Band and we would love you to become a
Band Patron for only £10 per year. To help us stay in touch with you and If you would like to
be informed of future events and other Band news please fill in the form below with your
details.

Name _____________________________________________________

Email Address: ________________________________________________

Address: .....................................................................................................................................
....................................................................................................................................................
.......................................................................................................................Post
Code: ..........................

Tel: ........................................................................................................

Patrons’ subscriptions are due on 1st October each year; where possible we encourage
people to pay by standing order as this eases the administration involved. A form is attached
for this purpose. However, you can opt to pay annually by cash or cheque if preferred.

The annual £10 subscription entitles you to a ticket to the Patrons’ Concert (usually held in
the Autumn) and to periodic newsletters.

Looking after your personal data:

Your privacy is important to us, and we want to communicate with band patrons and
supporters in a way which has their consent, and which is in line with UK law on data
protection. As a result of a change in UK law, we now need your consent to how we contact
you. Please fill in the details below on how you want us to use to communicate with you:

By signing this form you are confirming that you are consenting to the Bollington Brass Band
holding and processing your personal data for the following purposes (please tick the boxes
where you grant consent):-

I consent to the band contacting me by  post  phone or email.

☐ To keep me informed about news, events, activities where Bollington Brass band are
(note you can unsubscribe from the Bollington Brass band news letter at any time);
☐ To share my contact details with the Bollington Brass band Committee so they can keep
me informed about news, events, activities and concerts;

Signed: ______________________________ Dated: _______________________________

You can grant consent to all the purposes; one of the purposes or none of the purposes. Where you do not
grant consent we will not be able to use your personal data; (so for example we may not be able to let you
know about forthcoming concerts and events); except in certain limited situations, such as where required to
do so by law or to protect members of the public from serious harm. You can find out more about how we use
your data from our band secretary at Bollingtonbrassband@gmail.com

You can withdraw or change your consent at any time by contacting the Band secretary or at
Bollingtonbrassband@gmail.com Please note that all processing of your personal data will cease once you
have withdrawn consent, other than where this is required by law, but this will not affect any personal data
that has already been processed prior to this point.

Please complete all the details above and send the form, together with a cheque for £10 per
person (payable to Bollington Brass Band), to:

Bollington Brass Band, 78 Rugby Drive, Macclesfield, SK10 2JF

Thank you for your valued support!

 Standing Order Authority
(Please complete this form & take it to your bank)

To: .................................................................................... (name of your bank)

Address: ..........................................................................(address of your bank)

Please initiate the following standing order payment:

Amount: £.......... (in figures) ……………………………….. (in words)
on: ………………… (date) and annually thereafter until cancelled by me/us

Beneficiary name: Bollington Brass Band

Beneficiary bank: Lloyds TSB, Mill Street, Macclesfield
Sort Code: 77-67-08
Account Number: 15409660
Payments are to be taken from my/our account:
Account number: ……………………………..
Account name: ……………………………………………………………..
Signed: …………………………………………………… Dated ………………………