* NORTH PETHERTON GUY FAWKES CARNIVAL *

(Affiliated to Somerset County Guy Fawkes Carnivals Association)

 APPLICATION TO BECOME A PATRON OF NORTH PETHERTON CARNIVAL FOR 2010

Name

Address

Telephone Number

Email Address

Amount Donated

Cheques made payable to North Petherton Carnival

Please return this form to

N. P. Patronage Scheme, 7 School Fields, North Petherton, Bridgwater, Somerset, TA6 6QH

Before Wednesday 30^th September 2010 (Donations received after that date will be held over for the 2011 Carnival Season)

Many thanks.