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Form for Local Groups, Firms etc to join in subscribing to help spread the Charity Check Scheme.

To: Charity Check, 207 Imex House, Atlas Business Centre, Oxgate Lane, London NW2 7HJ (Tel 020-8438 0594 - Fax 020-8438 0646).

We wish to subscribe in support of the Charity Check scheme, and enclose a cheque (£35 / more - for one year)
to help our local District to be covered.

Name of Group/ Firm ............................................................ Date ....................  

Name of Officer  .............................................. Signature .......................................

Address ......................................................................................................................

Name of District Council or other Local Authority area ..........................................

Tel .........................         Fax .........................

Amount of cheque £ ....................

Charity Check is a non-profit Company Limited by Guarantee, registered in England 3222536