~ Please Print This Form ~

THE WAYNE HOWARD APPEAL FUND

SPONSORSHIP FORM – PLEASE USE BLOCK CAPITALS

 

Please Sponsor (name)    ………………………… of (address)………………………………………

 

…………………   on their (event)………………………………………on (date)…………………..

 

Sponsors are requested to pay their contributions to the sponsored
event participant within one month of completion of the event.

Sponsors Name

(Block Capitals Please)

Address Including Postcode + telephone number

Amount

Total

Paid

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Text Box: TOTAL  

 

DECLARATION

I have completed my (event)…………………………………………….and I promise to pay

The Wayne Howard Appeal Fund all monies pledge within 1 month of my event.

 

Signed……………………………………………… Participant

 

IMPORTANT

Please make all cheques (or postal orders) payable to “The Wayne Howard Appeal Fund”.  Please do not send cash. 

Send your sponsor money WITH THIS FORM to, “The Wayne Howard Appeal Fund, 16 Railway Cottages, Tate Road,
Old Redbridge, Southampton, SO15 0NL.  Alternatively pay directly to the
WAYNE HOWARD APPEAL FUND, ---Account number 00173230---sort code 16-31-37 held at The Royal Bank of Scotland.