Please print this form, make your selection from the choices below and return
this form together with a cheque for the correct amount made payable to DCGR to Ann Thomson,
Newlands, Eaglesfield, Lockerbie, Dumfriesshire, DG11 3AA. Tel 07710893889. Email meathomson@aol.com
[ ] Yes I would like to sponsor a DCGR kennel for £150
/ £100 / £50 / other amount ............. for one year
Please circle which kennels you want to sponsor Dalry / West Linton / Rockcliffe / Amount = £___________
[ ] Yes I would like to pay for the purchase of a weather proof
walking out
coat/s at £15.00 per coat. Amount = £___________
[ ] Yes I would like to pay for the purchase of a warm kennel coat/s
at £9.00
per coat. Amount = £___________
[ ] Yes I would like to pay for the purchase of a lead/s at £7.50
each.
Amount = £___________
[ ] Yes I would
like to pay for the purchase of a collar/s at £7.50 each.
Amount = £___________
[
] Yes I would like to pay for the purchase of a muzzle/s at £5.00 each.
Amount = £___________
[
] Yes I would like to pay for the purchase of a toy/s £5.00 - £0.99p
Amount = £___________
[
] Yes I would like to pay for the purchase of a duvet/s at £7.00
Amount = £___________
[ ]
Yes I would like to pay for the purchase of a duvet cover/s at
£9.00 each Amount = £___________
[ ] I would like to make a
donation of £ _____________
Please make cheque payable to DCGR
TOTAL £ _____________
Gift Aid it
Gift Aid Declaration: If you are a UK tax payer every
£1 you give could be worth £1.28 to us, all you need do is tick the box.
I would like the tax to be reclaimed on any eligible donations or membership subscriptions that I
have ever made or will make to the charity. I confirm that I pay an amount of UK income or capital gains tax at least equal
to the tax that the charity will reclaim.
□ Signed _________________________________
If this is a gift please write the name and address of the person you wish the certificate to be sent
too as well as your own name and address.
Your Name
Your Address
Name of person
to receive gift
Address to send
to if different e-mail Please
circle the appropriate responses Are you a member of Dumfriesshire & Cumbria Greyhound Rescue?
Yes / No Do you have / have had a greyhound? Yes / No Are you sponsoring/purchasing:
for yourself / as a gift? Where did you hear about the sponsoring/purchasing scheme? If this
is a gift, and you would like a message enclosed with your sponsorship/purchasing certificate, please write it below.
