Buy a brick

Or

Sponsor a seat

in the new Dr Peter Community Centre

Have your name immortalised or commemorate a special occasion with this unique gift and help us to build the new community facility for Romsey.

By making this donation, your message will be displayed in the Dr Peter Centre.

For more information about the Dr Peter Centre and to watch our progress, please visit our website at www.dr-peter-centre.org

Please complete the form below.

Cheques should be made payable to “Dr Peter Community Centre” and should be sent to:

Graham Hollier, 11 Brookfields, West Wellow, Romsey SO51 6GS.

Your name
Your address			Postcode
Telephone number (in case we have a query)
If you are a UK taxpayer, please tick if you are happy to treat this donation as Gift Aid
I would like to:
	Sponsor a Seat	(minimum donation £10)
	Buy a Brick	(minimum donation £5)
I would like my message to read: (maximum 50 characters or spaces over 2 rows)
Line 1:
Line 2: