Limehurst – Yew Clippings, Against Cancer   Other, please

Limehurst – Yew Clippings, Against Cancer
Correspondence address: 27 Brockhampton Lane, Havant, Hampshire PO9 1LZ
E-Mail: admin@limehurst.co.uk
Tel: 01243 555110 Hotline: 01243 575974
Please complete this form and either email or post it back to us. If you prefer to ring in with
the information we would be happy to hear from you.
Full Name(s):
Address:
Email address:
Go paper-free! And let us know your best contact email address 
DISCLAIMER: When we post bags out we’ll pop some info in the envelope,
but we aim to be as paper-free as possible with other correspondence
Payment preference,
Please tick the box below to let us know how you want the payment made.
CLIC Sargent donation

Bank Transfer

Bank account number:
Other, please specify
Sort code:
Name on account:
 _______________________________
You may wonder why we are asking for these details if you have already given them to us, but we need to have
annual up to date acknowledgement from you to ensure we have the correct information at the time. We will
safely destroy any sensitive information and never pass your details to third parties.
For more information visit www.clicsargent.org.uk