Milward's Millennium Motorcycle Ride

DONATION PRINT FORM

INDIVIDUALS + BUSINESSES

Print this page and fill in manually
or
select all text below, copy and paste into email or into your program for printing or fax

- complete the form -

and send it to

[Please now visit www.MotorcycleOutreach.org ]

NAME

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

POSTAGE ADDRESS

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

........... Country: ......................................

EMAIL ADDRESS

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

Amount of Donation ....................

Payment method:

CASH: Registered post only

O CHEQUE: to pay "Millennium Ride": Euros by Eurocheque & UK pound cheques OK

O BANK TRANSFER (Euro only) to:

DEXIA
Rue des Champs 6
B-1040
Account: Millennium Ride 088-2224132-14

^* Note: If you want to pay in currencies other than the Euro, please be generous regarding the exchange rate. This is because there will in any event be bank charges to cover.

THANK YOU FOR YOUR SUPPORT!