Please print
out and complete the relevant section of this form before sending
it here to us at Valleys Kids:
Valleys Kids
FREEPOST SWC3556
Tonypandy
CF40 1GZ
PLEASE COMPLETE EITHER PART A OR PART
B OF THIS FORM
PART A: Is to make a single donation by cheque
or postal order PART B: Is to make a regular donation by direct
debit
PART
A. This section is to make a single donation by cheque
or postal order.
Title:
Mr
Mrs
Ms
Miss
First Name:
Surname:
Address:
Postcode:
E Mail:
Telephone:
Mobile:
I would like
to make a single donation of:
(Please make
cheque or postal order payable to Valleys Kids)
Please
tick here if you are a taxpayer and would like Valleys Kids to reclaim
the tax on all your donations until further notice. This enables
us to claim 28p for every £1 you give at no cost to you.
PART B.
This section is to make a regular donation by direct debit. (print
form)
Title:
Mr
Mrs
Ms
Miss
First Name:
Surname:
Address:
Postcode:
E Mail:
Telephone:
Mobile:
BANKERS ORDER
FORM:
I want to
make a regular gift to Valleys Kids:
monthly/quarterly/annually (delete as appropriate) until further
notice starting on
_____ / _____ / _____.
Please debit
my account number:
Sort Code:
Name
of Bank:
Address:
To the Bank:
Please pay the above amount to Valleys Kids
Account Number:53117960, Sort Code:20 68 76
Barclays Bank plc, Tonypandy Branch, P.O. Box 32
Pontypridd, CF37 4YA
Please
tick here if you are a taxpayer and would like Valleys Kids to reclaim
the tax on all your donations until further notice. This enables
us to claim 28p for every £1 you give at no cost to you.
