ROTARY CLUB OF KENILWORTH

TREE OF LIGHT FORM 2009

Please print this form to fill in and send by post

I enclose a donation of  £...............................  

for Macmillan Cancer Support

for a light to shine on the Tree of Light

In loving memory  of

...................................................................................

Donor

Name .........................................................................

Address ......................................................................

...................................................................................

Post Code ...................................................................

Tel ..............................................................................

CHEQUES TO BE MADE OUT TO
ROTARY CLUB OF KENILWORTH.

Signature ....................................................................

I would like Macmillan Cancer support to reclaim
income tax/capital gains tax in this tax year to 
cover this gift.
       
Please circle YES/NO

and post form with cheque to:

Kenilworth Rotary Club Treasurer
11 Rose Croft
Kenilworth CV8 1AF

For any queries Tel 01926 779457