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Friends of the Hospital Application Form

Would you like to become a member of the new Friends of the Hospital?

Friends was established in February 2001 with the main objectives of promoting the aims and activities of the Hospital and to support its fund-raising campaigns.

Benefits to its members include a special enamel badge of membership, a twice yearly newsletter, invitations to Hospital functions, involvement in Archdeaconry events for the Hospital and other events planned by the Hospital or by the Friends.  

There is a small membership fee of £10 per year or life membership of £100, both including the cost of the badge.

If you would like to join, please complete and return the section below.  If you have any questions please do not hesitate to ring Elizabeth Mathew on .

I would like to join Friends of the Hospital and I enclose:

£10 for the year                  

£100 for Life Membership     

I do/do not wish to join Friends of the Hospital but instead wish to make a donation

I am a Taxpayer and wish this to be treated as Gift Aid

  I enclose cheque (payable to St. Luke's Hospital for the Clergy) for total amount       £_________

OR  Please charge my Visa/Access/Mastercard

No:______________________

Switch Issue No:______

Expiry Date:___________

Signed:_______________

Title:_____________

Name:_______________

Address:______________

______________________

_______________________

Post Code:_____________