Membership/Gift Aid/Response Form - fill out, print and sign.
(If you cannot print this form for any reason, please contact us at contact@midantrimanimalsanctuary.org
and we'll post you out the appropriate forms.)

Name :
Address Line 1 :
Address Line 2 :
Town :
County :
Postcode :
Home phone number :
Mobile number :
Email address :
DOB (dd/mm/yyyy) :
Commitment to Care Member (Monthly Payments)
Adult Member (£10 annually)
Senior Citizen/Junior Member (£5.00 annually)
I wish to Sponsor a Kennel (£100.00 annually)
I wish to sponsor a Long Term Animal (£60.00/£30.00 annually - dog/cat/small animal - please specify)
I wish to make a donation
I wish to be added to your mailing list
I wish to become a Volunteer/Fundraiser
 
I enclose a contribution to the total value of :
  £
  Cheques and postal orders made payable to Mid-Antrim Animal Sanctuary


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

Date: ..................................................................................................................................


If you wish to pay by Direct Debit, a printable form can be found here

GIFT AID DECLARATIONS (TAX PAYERS)
I want the Mid-Antrim Animal Sanctuary to treat all donations I have made since 6th April 2000, and all donations I make from the date of this declaration, until I notify them otherwise, as a Gift Aid Donation.
Signed: .................................................... Date: .........................................
(You must pay an anount of Income Tax and/or Capital Gains Tax at least equal to the tax that the charity reclaims on your donation in the tax year - currently 28p in the pound.)