London Marathon 2012 Pledge Form

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Company Information (if applicable) Company name: _________________________________________________________________________________________ Type of Business: ________________________________________________________________________________________ Address:___________________________________________________________________________________________________ _____________________________________________________________________________________________________________ Postcode: ___________________________________________ Job Title:_________________________________________ Registration Fee I would like to pay my registration fee of £20 by cheque (payable to Bede House Association) which covers some up-front expenses and is a sign of my commitment to the charity. I understand that my cheque will not be until my place is confirmed by Bede. Thereafter, this fee is non-refundable in the event of my withdrawal prior to the race or in the event of my getting my own place in the ballot. Fundraising What is your personal fundraising target? £ How will you raise this amount? (Please provide as much information as possible, as our decision on whether we can offer you a place on the team will be based on this information.) Registered Office: 351 Southwark Park Road, London SE16 2JW Registered Company Number 420386. Registered Charity Number 303199
Fundraising, continued... Why do you want to fundraise for Bede? Have you supported Bede in the past? Yes No (If yes, please give details opposite) Have you ever run the London Marathon before? Yes No (If yes, please give details opposite) Have you applied for your own place in the London Marathon? Yes No I will be*/ will not be* providing my own running t-shirt * Delete as appropriate Additional Information Please tell us how you found out about running the London Marathon on behalf of Bede Bede would like to keep you informed about our events programme. If you would prefer NOT to receive future information, please tick here. Please complete all pages, print off this form, sign and return to Vivien Palmer, Bede House fax at 020 7394 7586 or by post to Bede House, 351 Southwark Park Road, London SE16 2JW. For any queries, please call us on 020 7237 3881. We will let you know whether we can offer a place as soon as we can! Registered Office: 351 Southwark Park Road, London SE16 2JW Registered Company Number 420386. Registered Charity Number 303199
Page 1: London Marathon 2012 Pledge Form I

London Marathon 2012 Pledge Form

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