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YES! I would like to join the Kilner fundraising scheme

YES! Please send me  FREE Kilners Catalogues (please state quantity required/minimum 20) as soon as possible, so i can start earning cash-back funds for my organisation.

Has your organisation previously received catalogues via the Kilners Fundraising Scheme? No  Yes

IMPORTANT: Please clearly state (no abbreviations) full address of organisation. This is the name and address which will be used by us for our cheques.

SOURCE CODE (if known):

Title                                        Mr Mrs Ms Miss

Full Name *                           

Position in Organisation *   

Name of Organisation *      

Postcode *                          

Address Line 1 *                  

Address Line 2 *                 

Address Line 3 *                 

Town/City *                          

County                                

Country *                           United Kingdom

Email *                                  

Daytime Tel *                    

Mobile No                             

Fax No                                 

 * required fields

(We reserve the right to refuse any application)