ACA Crawley Donation Form

Once you have completed and printed your form, enclose it together with your cheque if applicable (cheques payable to Afro Caribbean Association) to the following address:
Afro Caribbean Association, PO BOX 546, Crawley, West Sussex RH11 7BU.

Name:   Tel. No.:
Email:
Contact Address:
 
Line 1:   Town/City:
County/State:   Country:
Postcode/Zip:  

I want to help the Afro Caribbean Association with a regular gift by standing order of:

£5   
£10   
£15   
£20   
Other   £

Each month until further notice starting on (date):
 (this should be at least one month from today)

To the manager (Bank/Building Society name):

Address:

Bank Sort Code: - -           Account Number:

Please debit my account with the payments detailed and pay to:
Afro Caribbean Society, Lloyds TSB Bank, (Sort Code: 30-12-51), (Account Number: 1034176)
SIGNED: DATE:   

OR I would prefer to make a donation to the Afro Caribbean Association of:

£5   
£10   
£15   
£20   
Other   £

I enclose a cheque made payable to the 'Afro Caribbean Association'   
 

THANK YOU FOR YOUR GENEROSITY