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Cheques should be made payable to: The Right to Live Campaign and posted to: DIRECT DEPOSIT DEBIT ORDER I would like to donate a monthly gift to the work of The Right to Live Campaign.
Please debit my bank account R _________ per month with effect from: Month: ___________ Year: ___________ Account (please tick) Cheque ___ Savings ___ Transmission ____ Account Holders Name : _________________________________________ Account Holders Postal Address: ___________________________________ Bank : ________________________________________________________ Branch & Branch No. : ___________________________________________ Account No: ___________________________________________________ Signature : __________________________ Date : ____________________ Tel (w) : ____________________________ Tel (H) : ___________________ DONATIONS ARE TAX DEDUCTIBLE |
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