REGULAR MONTHLY DONATION FORM
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Please print out this form, fill it in and return to: Save the Children, Freepost, London, SE5 8BR

Name and Address Name and Address:
Name in Full:
Mr/ Mrs/ Miss/
Ms/ Other
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Postcode: . . . . . . . . . . . . . . .

Telephone: . . . . . . . . . . . . . . .

NOW PLEASE COMPLETE YOUR BANKERS ORDER FORM
For office use only

Branch/Area Code to credit : MM54

Our Ref:


Save the Children Fund collection account 62-18-95/00000000 at National Westiminister Bank.


We may from time to time, allow companies who support our work or certain other charities to write to you. If you would prefer not to receive these communications please tick this box.

Please return to:

Save the Children
FREEPOST
London
SE5 8BR.

PLEASE DO NOT SEND THIS FORM TO YOUR BANK.
Thank You.
Bankers Order Form Your Monthly Bankers Order Form:
Yes I will help children with a regular gift.
Please pay Save the Children Fund [ ] £2 monthly
OR
My chosen monthly amount of
£ _________ (amount in figures)

Amount in words

My account number is

Bank Sort Code

Starting on (date) ______________ 19___ or immediately on receipt of this order whichever is the latest date and thereafter on corresponding dates.

To the Manager (name of bank and address if known)

____________________________

____________________________

____________________________

Postcode: ___________________


This Bankers Order cancels any previous standing order given by me in favour of Save the Children (Yes/ No/ Not Applicable) * Delete as appropriate


Signature


Date signed


[   ] Tick here if you are a UK tax payer and would like us to send you a form which will make this monthly gift into a covenant. This will increase the value of your gift by almost a third at no extra cost to you.