The Epiphany Centre

Name:

Address 1:

Address 2:

Village/Town/City:

Country:

Postcode:

Telephone:

Email Address:

I prefer to be contacted by: telephoneemail

I am prepared to contribute on a regular basis the sum of £
weeklymonthlyquarterlyweekly

I wish to give this by:

Donation:

Standing Order:

Gift Aid (I am a UK taxpayer):

I am interested in information about legacies:

I understand that I will be contacted, if appropriate, regarding standing order arrangements.

Please print this form and forward to:
Mr. K. Ousbey,
30 Lansdowne Avenue,
Audenshaw,
Tameside
M34 5SZ

COTE Community Association is a Limited Company with Charitable Status, Company Reg. No: 5075447 and Charity: 1105917

Name:
Address 1:
Address 2:
Village/Town/City:
Country:
Postcode:

Telephone:
Email Address:
I prefer to be contacted by:	telephoneemail

I am prepared to contribute on a regular basis the sum of £ weeklymonthlyquarterlyweekly

I wish to give this by:
Donation:
Standing Order:
Gift Aid (I am a UK taxpayer):
I am interested in information about legacies:

I understand that I will be contacted, if appropriate, regarding standing order arrangements.

Please print this form and forward to: Mr. K. Ousbey, 30 Lansdowne Avenue, Audenshaw, Tameside M34 5SZ