ADOPTION
                                                       APPLICATION
                                                             FORM






NAME OF BAT YOU WOULD LIKE TO ADOPT: ............................

 

YOUR DETAILS

 

TITLE:  (Mr/Mrs/Miss/Ms/Other) : ........................................

 

NAME:
.......................................................................................................

 

ADDRESS:
.................................................................................................

 

                         .............................................................................................

 

TELEPHONE No:
....................................................................................

 

EMAIL: 
....................................................................................................

 

NAME YOU WOULD LIKE TO APPEAR ON THE CERTIFICATE:

 

.............................................................................................

 

Where did you pick up this leaflet? …………………………………….

 

Tick as appropriate:

STANDING ORDER FOR £24 per year
STANDING ORDER FOR £2 per month
CHEQUE FOR £24 (1 year adoption)

 

Please make cheques payable to “E.D.B.R.R”

Please post form and Standing Order details/Cheque as appropriate to:

 

Marcia Nightingale, EDBRR, 5 French’s Farm
Road, Upton , Poole, Dorset BH16 5RT


 

 

Any queries please telephone:  07746 743221


                                            ----------------------


Standing Order Form to Adopt a Bat 

To(Please enter your Bank's name and address)                        






 

Please debit my account:

Account Name
Sort Code
Account Number
with the amount of £2/£24/£.................(Please complete or delete as appropriate)*
on the .....................Of the month/or..................every year(enter date) until further notice and pay to:


Account name: East Dorset Bat Rescue and Rehabilitation(E.D.B.R.R)
Sort code:       52-10-20
Account           11110228

Signed           ......................................

Dated             .......................................


Please send this form to E.D.B.R.R., 5 Frenchs Farm Road,Poole ,Dorset,
BH16 5RT and we will arrange for your membership pack to be sent to you and send this form to your Bank.

Thank you for adopting a bat(minimum donation £24 per annum)*










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