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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
0-6
7-11
11-16
In
Where the Need is Greatest
Bangladesh
Benin
Bolivia
Brazil
Burkina Faso
Cambodia
Cameroon
Chile
China
Colombia
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Ethiopia
Ghana
Guatemala
Guinea
Guinea-Bissau
Haiti
Honduras
India
Indonesia
Kenya
Laos
Liberia
Libya
Malawi
Mali
Mozambique
Myanmar
Nepal
Nicaragua
Niger
Pakistan
Paraguay
Peru
Philippines
Rwanda
Senegal
Sierra Leone
Sri Lanka
Sudan
Sudan, South
Tanzania
Thailand
Togo
Uganda
Vietnam
Zambia
Zimbabwe
First Name
*
If you are adding more than 1 name please use "and" instead of "&"
Surname
*
Contact Choices
All
Email only (NOTE: you will not receive updates on your sponsored child)
Phone only (NOTE: you will not receive updates on your sponsored child
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)
Afghanistan
Ă…land Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darrussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
CĂ´te d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Payment Method
*
Credit / Debit Card
Direct Debit
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Croke Park Abseil 2020 - Register Interest
Croke Park Abseil 2020 - Register Interest
Your name
*
Your phone number
*
Your email address
*
Where did you hear about our Treks & Challenges?
Word of Mouth
Social Media
Google Search
Our Website
Email
Leaflet or Insert
Press Article
Want to keep in touch with Plan International?
I am not happy to receive the ocassional update from Plan International Ireland
I am happy to receive the ocassional update from Plan International Ireland
Thanks for your support. It is so valuable to us and that’s why we ask your permission to update you from time to time to let you know how you are / can support our work.
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