Kayshill Animal
Sanctuary
Membership/Sponsorship/Donation
Form
Please fill
in this form so that we may process your request. Once you have completed all your details
simply post it to us along with your sponsorship fee to: M.S.D. F. Kayshill Animal Sanctuary, Stone
House Chapel, Bildershaw, West Auckland,
Payments by postal
order or cheque should be made payable to Kayshill Animal Sanctuary
If would like
to pay by standing order, please fill in the request form ensuring you insert
your surname and date of birth in the payment reference section instruction to
bank and take it to your bank.
Mr / Mrs / Ms / Miss Forename: ........................
. Surname:
.
Address: ...
...
...
....................................
..............................................................................................................................................................
County: .......
...
Postcode:
..... Tel No: ......................................
D.O.B
(dd/mm/yy)
................... Email
address
......................
Please tick
the appropriate box
□ Adult member (£10 annually) □ senior citizen/Junior member (£5 annually)
□ I wish to sponsor a zone (£240
annually) stable mates /
crazy cats / dozy dogs
Please circle
the appropriate zone farmyard friends /
flights of fantasy /
bunny burrows / rodents
shack
□ I wish to sponsor an animal (£100 /£60
/£30 annually) Animals name:
____________________
□ I wish to make a donation □ I wish to become a
volunteer/fundraiser
I enclose a
contribution to the total value of £__________________________________________
Payment
Method (please circle appropriate): cheque / postal order / standing order
Frequency
(please circle): annually / quarterly
/ monthly / one off payment
Signed_________________________________
Date_____________________________
If you would
like to sponsor an animal as a gift for someone else please fill in the details
below.
Mr / Mrs / Ms / Miss
Forename
Surname
...
.
Address:
...
...
.......................
County
:
.... Postcode:
................
...
.
Telephone Number:
Email address
.......
If completing
the form as a gift, the certificate and updates will be sent to the person
nominated. Receipt / renewal notification will be sent to
the person paying for the membership/sponsorship.
If you have
any questions or need help completing this form please telephone 01388 834996
THANK YOU FOR YOUR
SUPPORT