S E C T I O N S

Personal Details

Name*:

Address:

City:

Postcode:

Mobile*:

E-mail*:

Sex*:

 Female

 Male

 

 

Age*:

 Under 18

 19 to 25

 26 - 30

 

 

  31 - 35

  36 - 40

 > 40

 

Event (Fee £5 / person / sport / category )

Sport

Category

Description

Total

 

 

Total:

Mode of Payment

Paypal:

  Paypal ID is ‘smartman74@yahoo.com’

BACS :

     A/C Name:

Maharashtra Mandal London

 

Sort Code:

30-98-07

Acct No.:

0046 6042

Online Payment:

Please click on this link if you want to pay by credit/debit card. This link will open a new secured window.  However please ensure that you submit this form so that we have all your information.

https://mml.workwithus.org/Fundraising/Donate.aspx?page=701

Cash:

Comments:

 

                  

 

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