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Postal/Fax Application form to become a Friend of the Bog

Yes, I want to support the work of the Irish Peatland Conservation Council's Save the Bogs campaign by joining as a friend of the bog or by helping with 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.

If you would prefer you can phone or fax us with your credit card details and we will enroll you straight away. You can phone us on +353 - 45 - 860133 or fax us on +353 - 45 - 860481. If you have queries regarding payment you can e-mail us here bogs@ipcc.ie

Finally, if you feel you can support us by taking out a membership subscription by direct debit - either via a bank or credit card - the bank requires your signature on the form below, which you must send us.

Your personal details

Title ________ First Name ________________________________

Surname ___________________________________________________

Address ___________________________________________________

Town / City _______________________________

County / State _____________________________

Country __________________________________

Postcode / ZIP _____________________________

Date of Birth _________________ E-mail ______________________

Home Phone __________________ Work Phone ____________________

Friends of the Bog receive all these benefits:

• Our great welcome pack telling you all you need to know about IPCC's activities and events
• Free Visits to the Bog of Allen Nature Centre, Lullymore, Rathangan, Co. Kildare to include visitor centre, museum, gardens, wetlands and flytraps garden.
• Unlimited free visits to IPCC's Nature Reserves in Waterford, Kerry, Galway, Westmeath and Kildare
• The Save the Bogs Story. - a colourful magazine telling the story of our first 15 years of IPCC's campaign
• Our colourful and informative newsletter Peatland News twice a year which will keep you up-to-date with bog matters.
• Details of special events throughout the year including slide shows, excursions, walks and workcamps in your area.
• The knowledge that your support is helping to further the cause of bogs and their conservation.
• An IPCC campaign car sticker to display your support

  PLUS

• Teacher supporters also receive a 10% discount on all educational publications advertised in IPCC's special education and gift catalogue.
• In addition teachers are informed of special training courses run by IPCC
• Teachers can visit our exhibits at teacher conferences and shows.

Our subscription year runs from 1st of April each year.
At whichever level you choose to get involved your participation is welcomed and valued. Your commitment will help us plan our campaigns more effectively. No matter which way you decide to support us every penny counts in our fight to take action for bogs.

Please register me in the following supporter category

Euro 40 Individual for one year

Euro 45 Joint for one year (two adults at one address)

Euro 45 Family for one year

Euro 45 Teaching Friend for one year

Euro 27 Student / OAP / Unwaged for one year

Euro 45 Gift Enrolment for one year

Euro 100 Community Group for one year

Euro 750 Friend for Life

Euro 800 Corporate and Charitable Trusts for one year

In addition I would like to support the work of the IPCC's Save the Bogs Campaign with a donation of:

Euro 1250 Euro 600 Euro 450 Euro 250 Euro 50

Your amount: ________

(Please make your cheque / PO payable to the Irish Peatland Conservation Council)

Cash Cheque Postal Order Mastercard Visa Laser

Card Number ______________________________ Expiry Date ____ / ____

Security Code (last 3 digits on signature panel on back of card) _________

Signature____________________________ Date____________

SECTION B: PAYMENT BY BANKERS DIRECT DEBIT

If you wish to pay next years subscription and donation by Bankers Direct Debit, please complete this part of the form, and return it to IPCC.

I instruct you to pay Direct Debits from my account at the request of the Irish Peatland Conservation Council (IPCC).
I confirm that the amounts to be debited are variable and may be debited on various dates.
I shall duly notifiy the Bank in writing if I wish to cancel this instruction. I shall also notify Irish Peatland Conservation Council (IPCC) of such cancellation.

Date of first payment on or within one month of 1st April 20_____

Originators Identification Number
IRELAND 30-10-42
BRITAIN (BACS) 86-10-38

CUSTOMER ACCOUNT DETAILS

Your Signature ______________________________ Date ___________

Name(s) of Account Holder(s) to be debited: ________________________________________

Bank Account Number ____________________________

Bank Address __________________________________________

______________________________________________________

Bank Sorting Code ________________________________

Note: Mandates can be drawn only on current accounts held in the Republic of Ireland or the United Kingdom. Banks may decline to accept instructions to charge Direct Debits to certain types of accounts other than current accounts

The Direct Debit Guarantee
* This is a guarantee by your own Bank as a member of the Direct Debit Scheme, in which Banks and Originators of Direct Debits participate.
* If you authorise payment by Direct Debit, then
- Your Direct Debit Originator will notify you in advance of the amounts to be debited to your account
- Your Bank will accept and pay such debits, provided that your account has sufficient available funds
* If it is established that an unauthorised Direct Debit was charged to your account, you are guaranteed a prompt refund by your Bank of the amount so charged.
* You can cancel the Direct Debit Instruction in good time by writing to your Bank

Please print, sign and return the bankers direct debit form by post to the:
Irish Peatland Conservation Council, Lullymore, Rathangan, Co. Kildare, Ireland

If you wish to pay your subscription and donation by Access, Visa or Mastercard, please complete this part of the form and return it to IPCC.

I/We authorise, until further notice in writing, you to debit my/our Access/Visa/Mastercard, (delete as appropriate) on or immediately after the first of April annually, unspecified amounts which may be debited thereto at the instance of the Irish Peatland Conservation Council.

Credit Card Number

_____________/ _____________/ _____________/ _____________

Card Expiry Date ___________ Signature _________________________

Name & Address of card holder if different from that given above:

Name: ______________________________________________

Address: ______________________________________________________

_____________________________________________________________

Tel:_________________________________________________

Please print, sign and return the form to:
Irish Peatland Conservation Council
Lullymore
Rathangan
Co. Kildare
Ireland

Fax: +353-45-860133
Telephone : +353-45-860481
e-mail us here bogs@ipcc.ie