Patrons Joining Form
For all queries about Patron membership and the RA please contact the Patron Office T 020 7300 5885 E [email protected] W www.royalacademy.org.uk/support/patrons Patrons Office Royal Academy of Arts Burlington House Piccadilly, London W1J 0BD Follow us on twitter: @royalacademy Like us on facebook: facebook.com/royalacademy
Your support is our future
John Constable RA Cloud Study: Horizon of Trees, 27th September 1821 Oil on paper laid on board red ground, 25.8 x 30.5 cm Photo: © Royal Academy of Arts, London/John Hammond
Patrons Joining Form
I would like to join as an RA Patron
Option 2: Pay by Cheque or Card
I am giving £
I enclose a cheque made payable to ‘Royal Academy of Arts’ for £
Please debit my credit/debit card:
and I would like to be a:
Silver Patron £1,500 – £4,999
Benefit £600
Donation £900 – £4,399
Gold Patron £5,000 – £9,999
Benefit £1,000
Donation £4,000 – £8,999
Platinum Patron £10,000+
Benefit £1,600
Donation £8,400+
Patron Donor £1,500 +
Benefit £0
Donation £1,500+
Title:
RA Patrons
RA Schools Patrons
Benjamin West Patrons
Expiry Date:
First name:
Contemporary Circle Patrons
Gift Aid
Increase the value of your donation at no further cost to you. As a Patron all you have to do is complete the following Gift Aid declaration and the donation portion of your contribution to the Royal Academy will be increased by 25%.
Surname:
Home Address:
Security Code: CSV:
Signature: Date:
Young Patrons
Your details Title:
Surname:
Card Number:
And be part of the: (please select one Patron Group)
First name:
All we need is your consent - simply tick and sign the Gift Aid declaration below. Postcode:
X
Daytime Telephone Number: Email Address:
X
(FOR PATRONS E-NEWSLETTER)
I would like tax to be reclaimed on any eligible donations or membership subscriptions that I have made in the past 4 years to the Royal Academy of Arts, Friends of the Royal Academy and the Royal Academy Trust and all future gifts of money that I make from the date of this declaration until further notice. I am not eligible as a UK taxpayer/I do not consent
Title:
Payment methods Option 1: Pay by Direct Debit
2
5
8
6
3
To: The Manager (Bank/ Building Society Name)
7
First name:
Surname:
Home Address:
Postcode:
Membership reference (To be completed by the RA)
Bank /Building Society Address: Signature: Postcode:
Date:
Name(s) of Account Holder(s:) Branch Sort Code: Bank/Building Society Account Number: Membership reference: (To be completed by the RA) Instruction to your Bank/Building Society to pay by Direct Debit: Please pay the Royal Academy of Arts Direct Debits annually from the account detailed in this instruction, subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with the Royal Academy of Arts and, if so, the details will be passed electronically to my Bank/Building Society. Signature: Date:
PLEASE NOTE: BANKS AND BUILDING SOCIETIES MAY NOT ACCEPT DIRECT DEBIT INSTRUCTIONS FOR SOME TYPES OF ACCOUNT.
Gift Aid notes 1. You can cancel this declaration at any time by notifying the Royal Academy of Arts in writing. 2. You must pay an amount of income tax and/or capital gains tax at least equal to the tax that we reclaim on your contribution in the tax year. 3. If in the future your circumstances change and you no longer pay tax on your income and capital gains equal to the tax that the Royal Academy of Arts reclaims, you should cancel your declaration. 4. Please notify the Royal Academy of Arts should you change your name or address. The Royal Academy of Arts a registered charity under registered Charity Number 1125383 and is also registered as a company limited by guarantee registered in England and Wales with Company Number 6298947. The Royal Academy Trust is a registered charity with Charity Number 1067270. Friends of the Royal Academy is a registered charity with Charity Number 272926.
Please return this form to:
Patrons Office Royal Academy of Arts Burlington House Piccadilly, London W1J 0BD
Your support is our future
John Constable RA Cloud Study: Horizon of Trees, 27th September 1821 Oil on paper laid on board red ground, 25.8 x 30.5 cm Photo: © Royal Academy of Arts, London/John Hammond
Patrons Joining Form
I would like to join as an RA Patron
Option 2: Pay by Cheque or Card
I am giving £
I enclose a cheque made payable to ‘Royal Academy of Arts’ for £
Please debit my credit/debit card:
and I would like to be a:
Silver Patron £1,500 – £4,999
Benefit £600
Donation £900 – £4,399
Gold Patron £5,000 – £9,999
Benefit £1,000
Donation £4,000 – £8,999
Platinum Patron £10,000+
Benefit £1,600
Donation £8,400+
Patron Donor £1,500 +
Benefit £0
Donation £1,500+
Title:
RA Patrons
RA Schools Patrons
Benjamin West Patrons
Expiry Date:
First name:
Contemporary Circle Patrons
Gift Aid
Increase the value of your donation at no further cost to you. As a Patron all you have to do is complete the following Gift Aid declaration and the donation portion of your contribution to the Royal Academy will be increased by 25%.
Surname:
Home Address:
Security Code: CSV:
Signature: Date:
Young Patrons
Your details Title:
Surname:
Card Number:
And be part of the: (please select one Patron Group)
First name:
All we need is your consent - simply tick and sign the Gift Aid declaration below. Postcode:
X
Daytime Telephone Number: Email Address:
X
(FOR PATRONS E-NEWSLETTER)
I would like tax to be reclaimed on any eligible donations or membership subscriptions that I have made in the past 4 years to the Royal Academy of Arts, Friends of the Royal Academy and the Royal Academy Trust and all future gifts of money that I make from the date of this declaration until further notice. I am not eligible as a UK taxpayer/I do not consent
Title:
Payment methods Option 1: Pay by Direct Debit
2
5
8
6
3
To: The Manager (Bank/ Building Society Name)
7
First name:
Surname:
Home Address:
Postcode:
Membership reference (To be completed by the RA)
Bank /Building Society Address: Signature: Postcode:
Date:
Name(s) of Account Holder(s:) Branch Sort Code: Bank/Building Society Account Number: Membership reference: (To be completed by the RA) Instruction to your Bank/Building Society to pay by Direct Debit: Please pay the Royal Academy of Arts Direct Debits annually from the account detailed in this instruction, subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with the Royal Academy of Arts and, if so, the details will be passed electronically to my Bank/Building Society. Signature: Date:
PLEASE NOTE: BANKS AND BUILDING SOCIETIES MAY NOT ACCEPT DIRECT DEBIT INSTRUCTIONS FOR SOME TYPES OF ACCOUNT.
Gift Aid notes 1. You can cancel this declaration at any time by notifying the Royal Academy of Arts in writing. 2. You must pay an amount of income tax and/or capital gains tax at least equal to the tax that we reclaim on your contribution in the tax year. 3. If in the future your circumstances change and you no longer pay tax on your income and capital gains equal to the tax that the Royal Academy of Arts reclaims, you should cancel your declaration. 4. Please notify the Royal Academy of Arts should you change your name or address. The Royal Academy of Arts a registered charity under registered Charity Number 1125383 and is also registered as a company limited by guarantee registered in England and Wales with Company Number 6298947. The Royal Academy Trust is a registered charity with Charity Number 1067270. Friends of the Royal Academy is a registered charity with Charity Number 272926.
Please return this form to:
Patrons Office Royal Academy of Arts Burlington House Piccadilly, London W1J 0BD
