|
CAMPAIGN TO CREATE THE |
Please print out this registration form and post it to the address at the foot of the form
| Name | Please circle as appropriate: Mr/Mrs/Ms
|
| Address |
|
| Tel. No. |
|
| Please alert me by e-mail to news and opportunities for involvement (Yes/No) |
I agree to make a donation to LUNG for the amount of £10 £25 £50 £100 Other….. Cheques should be made payable to LUNG and posted with
your completed registration form to the address overleaf |
cont'd
I am able to contribute to the following LUNG activity streams: (please indicate any relevant skills that you have)
|
Please send your completed registration form to:
Mr. Ralph Cake
LUNG Treasurer
29 McKay Road
London SW20