Postal Donation Form

registered charity no 1108179

35 Avenue Road • Brentford • Middlesex • TW8 9NS

I wish to make a donation of ..£.................and enclose a cheque/money order
payable to: Transverse Myelitis Society

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

Address ........................................................................................

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

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

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

Postcode .............................

Telephone no..........................................................

Email .............................................................................................

If you are a UK taxpayer your donation will be worth more to the TMS under the Gift Aid scheme.

I am a UK taxpayer and would like the Transverse Myelitis Society to reclaim tax on this donation and on any donations I may make in the future.

Signed .................................................................... Date ........./.........../............

Please enclose this printed form with your cheque/money order and send to:

Transverse Myelitis Society
35 Avenue Road
Brentford
Middlesex
TW8 9NS

Thank you for supporting the Transverse Myelitis Society.