Provincial Office, 94 Birmingham Road, Bromsgrove, Worcestershire, B61 0DF Telephone: 01527 879300 e-mail provincial@worcestershirepgl.org.uk
Remittance Sheet Date sent ………………………………. Lodge/Chapter name
……………………...………
Date Received………………………….. Lodge/Chapter Number…………………….............. Member’s Donations/Gift Aid Name of Donor
Gift Aid (Y or N)
Net payment
Lodge/Chapter donations Source of Donation
Net Payment
£ NB: ALL CHEQUES TO BE MADE PAYABLE TO: WORCESTERSHIRE MASONIC CHARITY ORGANISATION Total amount of Cheque No: ………………………. £………………………..