ANIMAL ADOPTION FORM

Yes, I want to adopt one of the EASE animals and have selected the following :

__Amber __Sapphire __Rusty __Zig and Zag - £60

__Rosemary__Thyme __Cara - £30

The Adoption Fee will be paid:
-monthly by standing order (£10 per month)
-by cheque (£60 or £30)
-by bank transfer (£60 or £30)

Cheques need to be crossed and made payable to EASE. Information for bank transfers or standing orders can be found on the standing order form.

Name: .......................................................................................................

Title: (Mr/Mrs/Ms/Miss/other) .......................................................................

Address:.....................................................................................................

..............................................................Postcode: ...................................

Telephone: .......................................... Date: ...........................................

If you are a tax-payer, please enable EASE to claim a further 28% extra on top of your donations, by signing the following declaration.

I want EASE to treat all donations I make from the date of this declaration until I notify you otherwise as Gift Aid donations

Signature: ...................................................................................................

EASE, PO Box 292, Hatfield, Herts AL9 6JZ

STANDING ORDER AUTHORITY
(TO BE SENT TO YOUR BANK)

To: (Bank name and address) ......................................................................

.....................................................................................................................
Please pay: CafCash Ltd,
Kings Hill,
West Malling, Kent ME19 4TA
Sort code: 40-52-40

For the credit of: Environmental Animal Sanctuary & Education

Account No: 00010023

For the sum of: £ .........................

Commencing: .............................

And thereafter date due and frequency (eg 1st of each month)

......................................................until ................................. or until you receive further instructions from me/us in writing

Please debit my account accordingly.

My account no is: ....................................................................................

My account name is: ................................................................................

SIGNED ..................................................................................................

DATE ......................................................................................................