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IPCC's
Bogs & Fens Conservation Plan Support Form
I wish to give:
¤500 ¤250 ¤150 ¤75 ¤35 Other ¤ ____________
If you decide to make
a gift of ¤35 or more to IPCC's fen campaign today, we
will list your name as a supporter in our Fenland Conservation
Strategy Report to be published later this year
Please tick:
I do not require a thank you letter for my donation
I do
not wish to be acknowledged in the Fen Strategy Report
How to make a donation
In the interest of security
we recommend that you print out the form below and complete your
membership or donation details and send it to us through the
post or fax it to us . . . or . . .
if you would prefer you can
phone or fax or e-mail us with your credit card details and we
will enroll you as a supporter straight away. You can phone us
on +353 - 45-860133 or fax us on +353 - 45 - 860481.
Your personal details
Title ________ First Name
________________________________
Surname ___________________________________________________
Address ___________________________________________________
Town / City _______________________________
County / State _____________________________
Country __________________________________
Postcode / ZIP _____________________________
Date of Birth _________________
E-mail _______________________
Home Phone __________________
Work Phone ____________________
Please give what
you can - and remember that any donation you are able to make
will help.
Different ways you can
pay us
Please make your cheque
/ PO payable to the Irish Peatland Conservation Council
Cash Cheque Postal Order Mastercard Visa Access
Card Number ______________________________
Expiry Date ____ / ____
Signature____________________________
Date____________
Please print, sign &
return to:
Irish Peatland Conservation Council , Lullymore, Rathangan, Co.
Kildare
Ireland
Telephone : +353 -45-860133
Fax: +353 -45-860481
e-mail us here info@ipcc.ie
Irish Peatland Conservation Council Registered
Charity Number CHY6829
Copyright © Irish Peatland Conservation Council 2004
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