Friends of RSPCA South Godstone Donation / Membership Application Form:

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Name ......................................................................................................................................................................

Address ..................................................................................................................................................................

...............................................................................................................................................................................

............................................................................................................... Postcode .................................................

Email address ..........................................................................................................................................................

Please tick as appropriate:

I enclose a cheque for £ .............................................................................................................................................

Please complete the following standing order mandate if you would like to give regularly:

Your banks name.............................................................Your banks address ............................................................

.................................................................................................................... Postcode .............................................

Account name ...........................................................................................................................................................

Account number............................................................................................. Sort code ............................................

Please pay Friends of South Godstone Animal Centre the sum of £ ................(amount in words) .....................................

and each month/year thereafter. Please allow one month between signing this form and the date of the first payment.

Signature ...................................................... Date ......................................... Age if under 18 ...................................

For bank use only: Please pay Friends of South Godstone Animal Centre. Natwest 60-04-35 11007710

Please tick if you do not wish to receive further information from Friends of South Godstone Animal Centre

Application and donations should be sent to:
Friends of RSPCA South Godstone Animal Centre, Eastbourne Road, South Godstone, Surrey. RH9 8JB

Registered Charity No: 1110310

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