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Donation Form
(To print this form, click on File/Print or the 'Print' button in the toolbar at
the top of your browser)
Name:.............................................................................................................
Address:..........................................................................................................
......................................................................................................................
Tel:.....................................e-mail:.................................................................
By Cheque
I enclose a donation of £...................(cheques payable to:
Nicaragua Solidarity Campaign Action Group)
Return to NSCAG, 86, Durham Rd, N7 7DT
By Standing Order
Standing Order Form:
To the Manager: (Your bank/building society's name and address)
.............................................................................................................................................
Account Name (Name of your bank account)
...............................................................
Account Number.............................................
Sort Code (Your bank sort code) ............/........./.........
Please pay Nicaragua Solidarity Campaign Action Group ......£.....................
every month/year starting on ........./........./.........(date) until further
notice.
Signed.......................................
Date................................................
Credit A/C of: Nicaragua Solidarity Campaign Action Group,
Unity Trust Bank, 4 The Square, 111 Broad St, Birmingham B15 1AR
Sort Code 08-60-01 Account no. 20129945
Return to NSCAG, 86, Durham Rd, London N7 7DT
020 7561 4836
nscag@nicaraguasc.org.uk
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