I WOULD LIKE TO ADOPT: Owl Hedgehog Badger Otter PERSON MAKING PAYMENT


Mr/Mrs/Miss/Ms Address


Postcode


Daytime Tel. Email address


RECIPIENT (if different)


Mr/Mrs/Miss/Ms Address


Postcode Email address Age if under 18 years /


Please sign us up to be Cygnets: Number of children


/ (dd/mm/yy) (at £1 extra per month each)


I enclose a cheque (payable to ‘Secret World’) Please debit my credit card (Details below)


Card No. Exp. date


/ / Issue no. Cardholder’s Signature:


Gift Aid: I/we wish Secret World to reclaim tax on all donations I/we have made in the last 6 years, and all future donations I make hereafter.


/ / Security code


Current Account No. Sort Code:


Bank Instructions:


Please pay to the HSBC Bank Plc, 33 College Street, Burnham on Sea TA8 1AD for the credit of Secret World Wildlife Rescue, A/C 41226290, sort code 40-13-32 standing orders from the account detailed above.


Signature(s) Date


/ / (dd/mm/yy) For bank use only, please note the following Secret World ref: 11 - Postcode - / / (Block capitals please)


Your name: Mr/Mrs/Miss/Ms Address


Postcode


Please pay Secret World starting on the following date of £


(dd/mm/yy) the amount (minimum of £3) per month and thereafter until further notice.


Name of your Bank: Address


Fox


Standing Order instruction to your Bank to pay your annual adoption subscription:


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