ROTARY CLUB OF KENILWORTH
TREE OF LIGHT FORM 2010

[Please Print and Post this form]

I enclose a donation to Macmillan Cancer Support for a light to shine
on the Tree of Light in Talisman Square of

£. ...............................

The name I wished displayed is :

.........................................................................

Donor

Name.........................................................................

Address………………………………………………….

Post Code .................................................................

Tel .....................................

CHEQUES TO BE MADE OUT TO
MACMILLAN CANCER SUPPORT

Signature ............................................................

I would like Macmillan Cancer support to reclaim income tax/capital gains tax
in this tax year to cover this gift. Please circle

YES/NO

and send (with cash or cheque) to:

Macmillan Cancer Support
Fernhill Court
Ballsall Street
Balsall common
Coventry CV7 7FR