Pledge Form to print, complete and send to address below:

I/We am/are pleased to pledge a gift to the Topolski Memoir Appeal.

I/We will contribute a total of  £……………...

Signature………………………………………………………… Date…………….

Please include my/our gift towards your appeal total. 

I/We will complete a Gift Form to confirm the details of my gift by (Please specify date here) …………………………………..

Name

Address

Postcode

Telephone

Fax

Email

I/We would like to designate my/our gift towards the following project/item:

YES/NO you MAY/MAY NOT publicise my/our name as a supporter of the Topolski Memoir Appeal Please list my/our name/s as above or as............................................................

When you have completed the form please SEND to:

Jane Hellings, Topolski Memoir Ltd, c/o ABL Cultural Consulting, 31 St Martin’s Lane, London WC2N 4ER.

The Topolski Memoir is a registered charity no 1103516


To details on How to Give to Topolski Memoir