CICC Membership & Donation Information
(Version 2.0 -14/1/19)

Colchester Islamic Community Centre
Charity Number :- 1175376
Email address :- info@ciccentre.org
Postal Address :- Vicarage, Ivy Lodge Road, CO6 4EN
CICC
This is the CICC membership and donation application form. Please ensure you read the conditions associated with this application at the end of the form. (This is best done on a large PC screen.)
First Name *
Your answer
Surname *
Your answer
Gender *
Phone Number (mobile preferred) *
Your answer
Email *
Your answer
Postal Address *
Your answer
Post Code *
Your answer
Gift Aid
(please read full Gift aid text at end of page )
In order to Gift Aid your donation you must select this box :-
Donation Instructions
If property purchase project does NOT proceed, any unused donations I have given for this purpose should be
Select *
Signature
Please ensure you read the text at the end of the form. You must be 18 to become a CICC member.
Electronic Signature *
Your answer
Application Date ( day/month/year) *
Your answer
General Data Protection Regulation (GDPR)
A change in the data protection law (General Data Protection Regulation) means we won't be able to contact you after 25th May 2018, unless you confirm you are happy for us to do so. See data protection statement below.
Preferred method of contact
Donation & standing order Information
If you want to donate money to the charity this is the account Information you need to transfer the funds or
fill out your banks standing order form.
Bank Barclays, Cheshire CW9 7RB (if needed)
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Mosque & Islamic centre property account :-

Name CICC Property AC
Sort Code 20-45-45
Number 03922820
Reference (your name and post code)

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This account is for all activities excluding purchase of property :-

Name CICC General AC
Sort Code 20-45-45
Number 63854442
Reference (put activity title)
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