CICC Membership & Donation Information
(Version 2.0 -14/1/19)
Colchester Islamic Community Centre
Charity Number :- 1175376
Email address :-
Postal Address :- Vicarage, Ivy Lodge Road, CO6 4EN
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.)
Phone Number (mobile preferred)
(please read full Gift aid text at end of page )
In order to Gift Aid your donation you must select this box :-
I want to Gift Aid this donation and any donations I make in the future or have made in the past 4 years to CICC
If property purchase project does NOT proceed, any unused donations I have given for this purpose should be
Given to local mosque
Returned to me
Please ensure you read the text at the end of the form. You must be 18 to become a CICC member.
Application Date ( day/month/year)
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
WhatsApp (preferred option)
All of above
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)
Mosque & Islamic centre property account :-
Name CICC Property AC
Sort Code 20-45-45
Reference (your name and post code)
This account is for all activities excluding purchase of property :-
Name CICC General AC
Sort Code 20-45-45
Reference (put activity title)
Do you want to see the Information page
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service