I ENCLOSE A CHEQUE FOR _________
MEMBERSHIP CATEGORY (PLEASE TICK BOX)ٱ
INDIVIDUAL 8ٱ
UNDER 16 6ٱ
OVER 60 6ٱ
JOINT (TWO PEOPLE AT ONE ADDRESS) 12ٱ
FAMILY (UP TO FIVE PERSONS AT ONE ADDRESS, PLEASE PROVIDE ALL NAMES AND AGES IF UNDER 16 OR OVER 60) 20ٱ
LIFE 100 (PLEASE TICK IF UNDER 16 □ OR OVER 60 □)THESE AMOUNTS ARE ALL MINIMUM DONATIONS, IF YOU CAN AFFORD A LITTLE MORE IT WOULD BE VERY GRATEFULLY RECEIVED
NAME
ADDRESS
EMAIL
TELEPHONE
DATE
Please make cheques payable
to RSPCA West Dorset Branch or complete the following Standing Order Form.
If you are able to pay by Standing Order more of your money will go
directly to help the animals at Taylors.
You may cancel the Standing Order at any time.
FRIENDS OF TAYLORS
ANIMAL REHOMING CENTRE,
RSPCA WEST DORSET BRANCH,
PO BOX 5460,
WEYMOUTH,
DT3 6WH
(NOT TO YOUR BANK)
If you are a UK Taxpayer we
can reclaim the tax paid on your donation. Please complete the box below and
your donation will be worth nearly 30% more at no extra cost to yourself.
I
CONFIRM THAT I PAY INCOME TAX IN THE UK.
I WISH THE RSPCA TO RECLAIM TAX
ON MY DONATION OF
................
DATE
/ /
(Not valid if undated)
STANDING ORDER MANDATE
NAME OF
YOUR BANK / BUILDING SOCIETY
______________________________________________________
ADDRESS OF YOUR BANK / BUILDING SOCIETY BRANCH
______________________________________________________
______________________________________________________
______________________________________________________
PLEASE PAY NATWEST BANK PLC, BRIDPORT BRANCH,
ACCOUNT No. ______________ SORT CODE ____-____-____
FOR
THE CREDIT OF RSPCA WEST DORSET BRANCH
THE SUM OF (FIGURES) ______________________________
THE SUM OF (WORDS) _______________________________
COMMENCING (DATE OF FIRST PAYMENT) ________________
AND
THEREAFTER EVERY MONTH (OR) YEAR
UNTIL
FURTHER NOTICE IN WRITING.
PLEASE DEBIT MY ACCOUNT ACCORDINGLY
NAME OF ACCOUNT TO BE DEBITED ______________________
ACCOUNT NUMBER ___________________________________
SORT CODE _________________________________________
NAME _______________________________________________
SIGNED _____________________________________________
DATE ______________________________________________