RSPCA North Devon Branch

7 Brannam Crescent, Roundswell Commercial Park, Barnstaple, Devon, EX31 3TD



IN CASES OF CRUELTY, NEGLECT OR IN AN EMERGENCY

TEL: 0300 1234 999 (24 HOUR)


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PRINTABLE APPLICATION FORM

THANK YOU - WE REALLY APPRECIATE YOUR SUPPORT

RSPCA North Devon Branch Reg. Charity Number 207708

Lottery Licence Number LOO342



Full Name (in capitals):..........................................................................................................................................................

Telephone No:.......................................................................................................................................................................

Address (inc. postcode):........................................................................................................................................................

Name and Address of Bank: ..................................................................................................................................................

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

Account Number:...................................................................................................................................................................

Sort Code:.............................................................................................................................................................................

(I am 16 years old or over.)

Please pay RSPCA North Devon Branch £4.30 per month by Standing Order, commencing on .................................................. until further notice.



Signature:........................................................... Date: ...........................................

RSPCA North Devon Branch Details: Lloyds Bank, Ilfracombe, Account Number 7235928, Sort Code 30-94-52.

Please return completed form to The Lottery Co-Ordinator, 7 Brannam Crescent, Roundswell Commercial Park, Barnstaple, Devon EX31 3TD.