110TH ANNIVERSARY CEREMONY SIGN-UP & LOCOMOTIVE NAME PLATE DONATION FORM

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First Name

Surname

Membership status

Student Life Member

Student Annual Member

Life Member

Life Member (with LMC)

Town Member

Interested in becoming a member (we shall email you with details)

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Email (CRSid if a current resident member)

DONATIONS

Without the generosity of our members, simply this event and naming honour shall not be possible. We have a range of suggested amounts. Any donation over £10 includes a ticket and anything above £20 includes the awesome (and exclusive) CURC locomotive enamel badge.

Donation amount

£10

£20

£50

£100

Other (please fill out comments below)

I am not able to attend, yet I still wish to donate to ensure (please fill out comments below)

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Are you interested in our third sized plate with wooden plinth? £250 (plus postage) includes a ticket to the event and provides you a personal way to celebrate this occasion and honour bestowed on the CURC.

Yes, please contact me with details.

Maybe, I am interested, but would like to know more

No, just looking forward to the event

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Have you fallen out of touch with the CURC and wish to be put back onto our mailing list?

Yes

Already receive emails from "CURC Announce"

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Any comments?

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