Dean Bradley House 52 Horseferry Road London SW1P 2AF Tel: 020 7261 0447 Fax: 020 7633 0811 [email protected] www.wildlondon.org.uk Donation Form Name___________________________________________________________________ Address_________________________________________________________________ _______________________________________________________________________ _____________________________________________ Postcode __________________ Email ___________________________________________________________________ Please find enclosed my gift of £________________________ (please fill in amount) I enclose a cheque / Postal Order made payable to London Wildlife Trust OR Please debit my Mastercard / Visa / Maestro* Card No (* - delete as applicable) Bw Bw Bw Bw Bw Bw Bw Bw Bw Bw Bw Bw Bw Bw Bw Bw Valid from Bw Bw / Bw Bw Issue number (Maestro only) Bw Expiry date Bw Bw / Bw Bw CVC number Bw Bw Bw (last 3 digits on the signature strip on the back of your card) Signature_______________________________________________ Date _____________________ Thank you. Your gift will be used wherever the need is greatest. Please return this form to: London Wildlife Trust Part First Floor, Dean Bradley Housr 52 Horseferry Road, London, SW1P 2AF Protecting London’s wildlife for the future The London Wildlife Trust is a company limited by guarantee registered in England and Wales no. 1600379 and registered charity no. 283895.