| Please
print your name and address in block capitals |
| Name |
............................................................................................. |
| Address |
............................................................................................. |
| Address
(cont.) |
............................................................................................. |
| Postcode |
............................................................................................. |
Tel.
No.
in case of query |
............................................................................................. |
Please make cheques payable to "Phyllis
Tuckwell Hospice"
Please allow 28 days for delivery.
In case of any query call our Appeals
Office on 01252-729406 |