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SPONSORSHIP FORM - DOC 1

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					                                   N S P KU
                        The National Society for Phenylketonuria (United Kingdom)
                                                  Limited
                                                    Patrons
                        Ken Dodsworth MBE Anna Raeburn Dr Miriam Stoppard MD, MRCP Lady Teresa Carter

                                            SPONSORSHIP FORM
   Event

   Date                  Entrant



   PKU affects about 1 in 10,000 children. It is an inherited disorder which, if not treated, would cause brain
   damage. Fortunately this can be prevented by a special diet. The NSPKU exists to assist those with PKU and
   their families in managing this highly specialised diet and to promote further research.
                                                                                                 Total Amount for
   Name                              Address                                                     Completion




   Sponsorship payable to:-   NSPKU.
   Company No. 1256124                                                                        Charity No. 273670

                                   A Company Limited by Guarantee & Registered as a Charity
Company No 1256124                    Merrywood, Green Road, Wivelsfield Green RH17 7QD                 Charity No 273670
                                           Internet: http://web.ukonline.co.uk/nspku

				
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Description: SPONSORSHIP FORM