Supporters Membership form
Yes! I would like to become a supporter and make a donation to support the Pensychnant Foundation's work for conservation.

To send a cheque to the Pensychnant Foundation simply print out this form, fill it in and send it to:
The Pensychnant Foundation, Pensychnant,Conwy, Wales, LL32 8BJ
In a stamped addressed envelope

Name ____________________  

Address

 ____________________
  
  ____________________  
  ____________________  
Email ____________________  
I would like to donate £ ____________________ (minimum donation £10.00 to become a supporter)
I have enclosed a cheque made payable to the Pensychnant Foundation

Help the Pensychnant Foundation increase the value of your gift by almost a third - at no extra cost to you:

Yes, I would like the Pensychnant Foundation to treat the donations I make from today's date as Gift Aid donations, therefore qualifying for tax relief, until I notify you otherwise. I understand that the tax the Pensychnant Foundation reclaims on these gifts (currently 28p for every £1 I give) must not exceed the total amount of income and/or capital gains tax which I pay in any tax year.

Signature ____________________
Date ____/____/____

 

Tick here if you would prefer not to receive further communication from the Pensychnant Foundation.

We will not make our mailing lists available to any other organisations.