Order Form

Quartiere Pianello

Save San Pietro Montalcino Tuscany

POSTER DONATION FORM

Your NUMBERED LIMITED EDITION poster of Ventura Salimbeni's
"Glorification of the Eucharist", Montalcino Tuscany, 1600

Please print or save this page, complete your order form and forward the form to "Save San Pietro" following the instructions on this page.

Your donation of a minimum Euro 195,00 (US$270.00) (includes postage and packaging) will be rewarded with an exclusive, Limited Edition Numbered Poster.

Your donation can be made by:

Direct bank wire transfer to "Quartiere Pianello Salviamo S. Pietro" fundrasing bank account Montalcino, Tuscany ITALY.
Not Negotiable banker's cheque made payable to "Quartiere Pianello Salviamo S. Pietro" and sent to the postal address below.

(please note that your donation must be made in Euro currency and must include your bank's transfer fees so that your donation of a minimum Euro 195,00 (US$270.00) per poster remains intact and not reduced by transaction fees)

MY ORDER:

Please accept my donation of *Euro/US$ ............................. and send me ............* Numbered, Limited Edition poster/s of the Glorification of the Eucharist by Ventura Salimbeni.

*Please indicate your currency and how many posters you wish to order.

Name & Surname
Postal Address
Telephone Number
E-mail

PRIVACY CLAUSE: We respect your privacy. By completing this order form for “Save San Pietro” we have access to your personal contact information. This information will be safeguarded by “Save San Pietro” and WILL NOT be made available or disclosed to any other parties.

Our website contains a page entitled “Donations received to date” (www.save-san-pietro-montalcino.com/donations_list.htm). We would like to acknowledge your donation on this page but will only do so with your consent. We would include the following details:

Name and Surname, Country, Amount Donated, Date

Business name, Country, Amount Donated, Date

I consent to my name, surname, country of origin, amount donated and date being included on the

www.save-san-pietro-montalcino.com/donations_list.htm website page.

I DO NOT consent to my name, surname, country of origin, amount donated and date being included on the www.save-san-pietro-montalcino.com/donations_list.htm website page.

(Please strike out which of the above is NOT applicable)

INSTRUCTIONS: HOW, WHEN AND WHERE: Send your completed Order Form by e-mail, post or fax.
BY POST:	Save San Pietro Via Delle Scuole 3 53024 MONTALCINO (SI) ITALIA
BY FAX:	39-0577-848712
BY E-MAIL:	isabella@save-san-pietro-montalcino.com

On receipt of your completed Poster Donation form by post, fax or e-mail we will allocate you a Numbered Poster from the Limited Edition and advise you of your poster number. When you receive your Limited Edition poster number, you should immediately make your donation and advise Save San Pietro Committee by e-mail, fax or post the date and method by which your donation has been made (Banker's Cheque or Direct Bank Wire Transfer). Your reward, your Numbered Poster, will be dispatched within one week of your donation reaching the Save San Pietro fundraising account. THANK YOU!
SEND YOUR BANK CHEQUE DONATION BY POST via registered mail and addressed to:	Save San Pietro Via Delle Scuole 3 53024 MONTALCINO (SI) ITALIA

SEND YOUR DONATION BY DIRECT BANK WIRE TRANSFER:
Benificiary:	Quartiere Pianello Salviamo S. Pietro
Account Number:	4267.95
Bank details, address and codes.	MONTE DEI PASCHI DI SIENA Via Matteotti 45, MONTALCINO (SI) ITALIA SWIFT- PASCITMMMTC CODES: ABI: 1030 CAB: 25500 CIN: M
IBAN CODE:	IT 19 M 01030 25500 000000426795
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