CASHBACK CLAIM FORM EVENT: Santa Specials 2017: Meet Santa Claus & guests on a festive heritage train ride. DATE & TIME: 2nd to 23rd of December 2017 PAY BACK PER MEMBER + 1 child: £14 (£13 if a family ticket is purchased) CSSC MEMBER - HEAD OF PARTY: ……………………………………………………………………….. FULL NAMES OF ALL IN YOUR PARTY, INCLUDING YOURSELF Contact Tel No. FULL NAME CSSC No. Email address (H/W/M)

TOTAL NUMBERS TOTAL CLAIM £ (add rows if claiming for more than 10 members including yourself)

I certify that I am a member of CSSC Tyne, Wear & Northumberland Area and have booked tickets fo r Santa Specials 2017 for the members on this claim form. I wish to claim a ‘cashback’ subsidy for ea ch member.

All ‘cashbacks’ will be by BACs transfer. Please complete the details below and sign and date the clai m form.

Account name: Account No: Sort Code:

Signature: Date:

Send with receipts to: [email protected] or post to Jackie Ilderton, 20 Murray Road, Howdon, Tyne & Wear, NE28 0LZ

N.B. Settlement of your claim will be made after the event has taken place; please allow a month bef ore considering further contact. Application closing date 30/11/17 or when 50 places have been b ooked.

For official use only:

Date paid: Payment Ref: IMPORTANT NOTES OVERLEAF – YOU MUST READ AND UNDERSTAND THEM!  ‘Cash back’ claims must only be made for CSSC TWN members

PTO  "Enter the CSSC number for all members". (Any member who does not know their membership number should contact CSSC Head Office on 01494 888415/418) work and mobile number  Any member found to have claimed a ‘cash back’ for non-member(s) attending the event may be suspended from membership.  All claims are on a ‘first received – first paid basis. Once claims for 50 members have been received, no more cash backs will be considered. Members should therefore be aware that they could potentially have to pay cost price for the event if the claim is received after 50 ‘cashback’ claims have been made.  For audit purposes, a post event % check will be undertaken to confirm that the CSSC TWN m embers on this form did, in fact, attend the event and a refund of the ‘cash back’ will be sought from the Head of Party for any member found not to have attended the event in their claim.