Lime Tree House – Donation Form

Please return this form, when completed to: 'The Administrator', Lime Tree House, 264 Washway Road, Sale, Cheshire, M33 4RZ.

I would like to make the following donation to Mountlands Trust Ltd, Registered Charity 219215. Please make cheques out to Mountlands Trust Ltd. as Mountlands Trust Ltd. operates Lime Tree House.

Donation of £ (please tick below for which purpose you wish your donation to be used)

General Fund (for operation)

Benevolent Fund (for patients)

Maintenance Fund

Any specific purpose:

Name

Address

Signed

Date

Please return this form to: 'The Administrator', Lime Tree House, 264 Washway Road, Sale, M33 4RZ.

Lime Tree House: Donation Form