To make a monthly donation to Ayrshire Cancer Support, please fill out the form below, print it and then post it to:

Ayrshire Cancer Support
FREEPOST
N A T N 589
Kilmarnock KA1 2BR

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Monthly Standing Order

Name of bank:	*
Address of bank:	*
Monthly donation:	£ - pence *
Starting on:	Day: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month: 01 02 03 04 05 06 07 08 09 10 11 12 Year: 2005 2006 2007 2008 2009 2010 2011 2012 2013 2015 2016 2017 2018 2019 2020 *
Account No:	*
Sorting Code:	- - *

Gift Aid Declaration

If you are a UK taxpayer, you can make your gift worth even more at no extra cost to you. Please complete the Gift Aid Declaration which will make every £1.00 you donate worth an extra 28p. It's easy and means we are able to do so much more.

Title:	Mr Mrs Ms Miss Dr
Donors Name:
Address:
Postcode:

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When you have completed the form click on the print button to confirm your details.

Fields marked with an asterix (*) are required.