Pledge Cards

You might also like

Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

Pledge card

Im helping in the fight to reverse Rett Syndrome


Full name: ......................................................................................................................
Billing address: ............................................................................................................
............................................................................................................................................
Town:....................................................................Postcode:........................................
Email:................................................................................................................................
Home Phone:................................................................................................................
Card type:.......................................................................................................................
Name as it appears on card: ..................................................................................
Credit card #:................................................................................................................
Ex. date: ............................................ Security code:...............................................
Donation amount: .....................................................................................................
I authorize Rett Syndrome Research Trust UK to
charge my credit card as indicated above.

Cardholders signature:............................................... Date:...................................








We would like to keep you up to date on the work of Rett


Syndrome Research Trust UK. To receive our regular email
newsletter, please tick this box.
Please tick here if you would like Rett Syndrome Research Trust UK
to reclaim the tax you have paid on this donation. In order for Rett
Syndrome Research Trust UK to reclaim the tax you have paid on
your donations, you must have paid income or capital gains tax (in
the UK) equal to the tax that will be claimed. We currently receive
25p in every pound.

Thank you

You might also like