RSPCA Chesterfield & North Derbyshire Branch

By providing us with these details you are giving permission for the RSPCA Chesterfield & North Derbyshire Branch to contact you by these means

Name *

Address *

Postcode *

Phone *

E mail *

Who is the sponsorship for? For me A gift* In memory of a pet**

*Name of person receiving sponsorship as a gift

*Address

*What is the occasion for the gift?

**If the sponsorship is in memory of a pet please include a short message below:

I would like to sponsor Dog Kennel at £8 per month
Cat Pen at £6 per month
Rabbit Hutch at £3 per month
I would like to sponsor another amount*

*Please enter another amount you would like to sponsor per month

If you are a taxpayer, please indicate if you would like the RSPCA Chesterfield & North Derbyshire Branch to Gift Aid your contributions and increase your donation by a quarter.  You must pay an amount of Income Tax and/or Capital Gains Tax for each year (6th April one year to 5th April the next) that is at least equal to the amount of tax that the charity will reclaim on your gifts for that tax year.

Would I like to Gift Aid my donation? Yes No

Would you like to receive further information from the animal centre? Yes No

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