Love Story Debit Order Pledge Form
Name:
Your answer
Surname:
Your answer
Email Address:
Your answer
Cell Phone Number:
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I pledge to make the following monthly donation:
Thank you for your donation!
The Love Story team will record your details and will touch base with you to confirm your pledge. You will then receive an authorization form to print off, fill in, scan and send back to us.

Thank you again for your donation.

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