WEST MIDLANDS PALESTINE SOLIDARITY CAMPAIGN

pscwm@yahoo.co.uk ; tel: 07596994846; website : http://www.westmidspsc.org;

Facebook page: West Midlands Palestine Solidarity Campaign

12, Dowles Close, Selly Oak, Birmingham B29 4LE

DONATIONS & STANDING ORDERS

DONATION FORM

I enclose a donation of □ £5 □ £10 □£20 □£50 □Other £……..

You can donate through online banking from your account. Please give our bank details as follows :

Account name : West Midlands Palestine Solidarity Campaign; Account number 65190544; Sort code : 089299.

Please put your name in the reference box so that we can write to thank you.

If you are sending a cheque (address above) please make cheques payable to : West Midlands Palestine Solidarity Campaign and return this form to the address above.

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STANDING ORDER FORM

Name
Address
Postcode
Telephone
e-mail
Bank Name
Bank Address
Postcode
Account no.
Sort Code
Please Pay	Please pay □£5 □ £10 □Other (please specify)
At interval	□ Every year □ Every quarter □ Every month
From Date	until further notice
To	Account name : West Midlands Palestine Solidarity Campaign; Bank : Co-operative, PO Box 250, Delf House, Southway, Skelmersdale WN8 6WT; Account no 65190544; Sort code 089299
Name
Signature
Date

Please return this form to the address above

Thank you