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Standing Order Donation Form

Month. Quarter. Year. Your Bank Details:. To The Manager Bank/Building Society: Bank Address: Name of Account Holder: A/C number: Sort code:. Your Details:. Name: Address: Phone: Email:. Standing Order Donation Form.

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Standing Order Donation Form

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  1. Month Quarter Year Your Bank Details: To The Manager Bank/Building Society: Bank Address: Name of Account Holder: A/C number: Sort code: Your Details: Name: Address: Phone: Email: Standing Order Donation Form I would like to set up a Standing Order of € every: (please tick one) If you are a PAYE tax payer a donation of €21 per month / €63 per quarter / €250 per year will mean that Cork ARC can claim back any income tax already paid, so your gift could be worth up to 42% more to Cork ARC at no extra cost to you! These payments are to go to Cork ARC Cancer Support House: Bank Address: Permanent TSB, 1 Lapps Quay, Cork • Account no: 71947872 • Sort code 990701 Signature: Date: FOR PEOPLE LIVING WITH CANCER AND THOSE WHO CARE FOR THEM. Cork ARC Cancer Support House Cliffdale O’Donovan Rossa Road Cork Tel: 021-4276688 www.corkcancersupport.ie

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