PHYLLIS TUCKWELL HOSPICE
Waverley Lane, Farnham, Surrey GU9 8BL

GO YELLOW QUIZ
(courtesy of St Cuthbert’s Hospice)

£2.50 per quiz or £10 for all 5 quizzes
There will be a prize for each quiz and one for people who do all 5 quizzes (prize details to follow)

Please print this Quiz Form and the actual quizzes on the following pages. Complete the quizzes you wish to take part in, and mail to Phyllis Tuckwell Hospice (address above) with a cheque made payable to Phyllis Tuckwell Hospice.
 

Please enter me in the following quizzes at £2.50 each or £10 for all 5 quizzes
ROUND 1    
ROUND 2  
ROUND 3  
ROUND 4  
ROUND 5  
TOTAL ENCLOSED:    £…………………
FIRST NAME .............................................................................................
LAST NAME .............................................................................................
TITLE .............................................................................................
ADDRESS .............................................................................................
  .............................................................................................
POSTCODE .............................................................................................
DAYTIME TELEPHONE NO .............................................................................................
E-MAIL .............................................................................................
SIGNATURE .............................................................................................
 

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Round One