Worcestershire Animal Rescue Shelter : 100 CLUB



NAME : ............................................................................................

ADDRESS : ......................................................................................

............................................................................................................



I enclose a cheque for :

£60 (annual) ........

£30 (half-year) ........

£15 (3 months) ........

made payable to Worcestershire Animal Rescue Shelter. I confirm I am 18 years of age or over.



Signed ............................................................

Please return this form to :

Mrs S Cridland, 12 Orchard Way, Leigh, Worcester WR6 5LF