PLEASE PRINT THIS FORM OR SEND THE INFORMATION BY LETTER
FRIENDS OF THE SHELTER FORM
Please enrol me as a member of the “FRIENDS OF THE SHELTER” scheme
NAME:
ADDRESS
Please enter your cash/cheque donation (min £15) here or if possible complete the Bankers Order Form below. Thank you.
I enclose a cheque/cash for ____________________________
BANKERS ORDER FORM
Please send this form to the Animal Shelter, NOT your bank.
To: The Manager ________________________________________
Bank Address in full _____________________________________ Bank
______________________________________________________
______________________________________________________
_______________________ Postcode ______________________
Sort Code: __ __ __ __ __ __
Please pay the Destitute Animal Shelter £ ____________
every month/quarter/year (delete as appropriate)
The minimum payment is £15 per year
Starting on ________________________
Please make the date at least one month from now.
Until countermanded. Direct Debit my/our account number
__ __ __ __ __ __ __ __
Signed ______________________________________________
Date: ______________________________
Pay to: The Destitute Animal Shelter, A/c No. 12744386 (16 00 06),
Royal Bank of Scotland, Central Branch, Deansgate, Bolton.
PLEASE POST THE COMPLETED FORM TO
THE DESTITUTE ANIMAL SHELTER
1 NORTHOLT DRIVE. BOLTON. BL3 6NJ
