Projected Picture Trust Membership Form

Title, first name and last name *

Street Address

Address Line 2


State / Province / Region

Postal / Zip Code

Phone Number *
Email Address *
Confirm Email Address *
Type of Membership *
Names of family members
Present occupation/affiliations/specific expertise and skills
Member of the following: (Ticki as appropriate)
How did you hear about the PPT?
Gift aid declaration

If you are a UK taxpayer, your membership subscription and any donation can be treated as a gift aid donation. In order to be of benefit to the Trust, you must pay an amount of income tax
and/or capital gains tax at least equal to the

I declare that I wish The Projected Picture Trust to treat my subscription and any donation to the Trust, from 6 April 2000,
as a gift aid donation.
Data Protection statement. By signing below you agree that your personal information will be held and used in accordance with the Data
Protection Act 1998. The PPT will not disclose such information to any unauthorised person or body. We only use the info
Yes, I agree
Apart from the paper copies of ‘Rewind’ which are sent via the Royal Mail we also send out emails to keep members up to date. Would you like
your email address to be added to this?
Yes please
No thank you
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