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DONATE

ONE-TIME DONATION

Please print this page, complete and return to the following address:

The Anita Goulden Trust,
144 Bronsart Road,
London, SW6 6AB, UK.

Please find enclosed a cheque/postal order (Payable to The Anita Goulden Trust)
for the amount of £………

Name:

Address:



Postcode:

Receipt Required?:  Yes    No

I am eligible for Gift Aid?:*  Yes    No

*If Yes please fill in the Gift Aid form as well

Sign:

Date: