DONATION FORM

Please print the form below (go to the 'File' menu in the top left of your browser, and select print).

Fill in the form and send it with your donation to:

LEJoG ride 2005/ The Brittle Bone Society

30 Guthrie Street

Dundee

DD1 5BS

I/We wish to support the Brittle Bone Society and enclose a cheque made payable to The Brittle Bone Society in the sum of £...................

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Please tick this box if you are a UK tax payer and wish us to reclaim the taxable Gift Aid contribution to add to your kind donation.

Thank you.