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To make a donation to the Pollyanna Pickering Foundation please
print this page (ctrl+p), and fill in the form.
Send with a cheque, postal order, or credit card details to
:
The Pollyanna Pickering Foundation, The Gallery, Brookvale
House, Oaker, Matlock, Derbyshire, DE4 2JJ, UK
or fax to 01629 55851
Address Line 1............................................................................................................................................
Address Line 2............................................................................................................................................
Town..............................................................................................................................................................
County............................................................................................................................................................
Postcode........................................................................................................................................................
I enclose a cheque/postal order for a total of ________________
made out to The Pollyanna Pickering Foundation
Please debit my mastercard/visa/amex/switch/maestro
card with a total of___________________
Card Number : __ __ __ __ /__ __ __ __ /__ __ __ __
/__ __ __ __
Start date __ __ / __ __ Expiry Date__ __ / __ __
Issue Number ____ (Switch only)
Security code __ __ __ __ (the last three
digits of the number above the signature strip on the back of
your card or for Amex : four digits on the front of the card
)
email address in case of queries___________________________________________________
If you would like your donation to go towards a specific
Fundaraising campaign please indicate below :
____ Ethiopian Orphanage Library Appeal
____ Ethiopian Wildlife Sanctuary
____ Cheetah relocation Fund
____ Tiger Orphange
____ Giant Panda appeal
____ British Widlife Rescue
Other - Please specify :
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