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Fen Campaign Support Form

Yes, I want to help protect vanishing fens

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 - 1- 8722384 or fax us on +353 - 1 - 8722397.

Your personal details

Title ________ First Name ________________________________

Surname ___________________________________________________

Address ___________________________________________________

Town / City _______________________________

County / State _____________________________

Country __________________________________

Postcode / ZIP _____________________________

Date of Birth _________________ E-mail _______________________

Home Phone __________________ Work Phone ____________________

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
119 Capel Street
Dublin 1
Ireland

Telephone : +353 -1-8722397

Fax: +353 -1-8722397

e-mail us here info@ipcc.ie