Your contributions are much appreciated

Please print off this form and send with a cheque made payable to 'SUSILA DHARMA (BRITAIN)', to:

Stephen Weil
 Susila Dharma (Britain)
126 Doversgreen Road
Reigate, Surrey
RH2 8DW
UK

Please write clearly in BLOCK CAPITALS

Name: _______________________________________________________

Subud Group (If applicable): _______________________________________

Address: ______________________________________________________

_____________________________________________________________

City / Town: _______________________________ Post Code: ___________

Amount Donated _______________________________________________

For General Fund Y/N_______ Other (State Project if N)_____________________

The Directors of Susila Dharma (Britain) would prefer that donations are marked for the 'General Fund', in order that they may decide on allocation of funds relative to most pressing needs at any given time. Should you prefer to support an individual project, however, please mark this form or your covering letter with the name of the project(s) you wish to support, and these funds will be channelled to your chosen project(s). Thank you.