Mango Sponsorship DRTV – Plan International Ireland

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Contact Centre Sponsorship Form DRTV15

THIS FORM IS ONLY TO BE USED FOR NEW CHILD SPONSORS FROM THE TELEVISION CAMPAIGN.

Monthly Amount*
Frequency*
- Monthly
- Annually
I would like to sponsor*
- DRTV Girl
- DRTV Boy
- DRTV The child waiting the longest
Age
In
First Name*
If you are adding more than 1 name please use "and" instead of "&"
Surname*
Contact Choices
Email*
Enter Email Confirm Email

NB. CONTACT CENTRE FUNDRAISER EMAIL ADDRESS
Comments
Including DONORS EMAIL ADDRESS, OTHER INFO etc..
Phone*
Address*
Street Address * (Required) Street Address 2 (Optional) Town / City * (Required) Country
Payment Method*
- Credit / Debit Card
- Direct Debit