ORM Hold Her Hand Programmes

Page 1

Hold Her Hand Programmes

Medical

Educational

Social

Cultural

________

The nature of sponsorship funding means we can commit to making these long-term changes in their lives, not just quick fixes. We can plan for their future and give them stability, health, education and recognition.

This programme is open to:

Individuals Groups Schools or individual classes within a school Organisations & Businesses You will receive information of how your sponsorship made an impact in the life of a children, these will be emailed updates including photos and videos.

Sponsorship Form

________

Outreach Moldova is an Irish registered Charity set up in 2000 to bring both medical and humanitarian assistance to severely disabled, orphaned and abandoned children in the Republic of Moldova. When you sponsor a programme with ORM you can help provide hope for these children with disability, terminal illness and often their whole communities. You as a sponsor get a chance to stand up for the rights of a child in need. Your sponsorship will go towards education, medical and social care. Where possible it will go towards sponsoring a reintegration of the child back into their biological or extended family as part of our social care programme. Your engagement and participation in our Child Sponsorship Programme will make a huge difference to the daily lives of the children in the care of ORM. Our commitment to the children and the life changing development programmes is dependent on your generosity. Thank you for taking the time to complete the sponsorship form with a generosity of spirit that will ensure the long term viability of these programmes.


I want to sponsor: Medical Physiotherapy Speech Therapy Dentistry

School Music/Dance/Sport Arts & Crafts Dressmaking

by making a monthly/yearly donation of €5 €10 €15 €20

€25 €50 other

Would you like to receive updates on your sponsored programme?

Yes

No

Payment Options (please circle one option)

1) Standing order monthly/annual: please complete the form below for the bank and return to us to the address: Suite 104, DMG House, Deansgrange Business Park, Deansgrange, Co. Dublin, Ireland 2) Credit card (online in our website: www.outreachmoldova.org click on “make a donation” and complete the form quoting “ HHH”in a reference field 3) Cheque payment, payable to Outreach Moldova. Return the cheque with this form completed with your details.

Request for Standing Order

To: The Manager __________________________________________________________ Bank Name: ______________________________________________________________ Bank Address: ____________________________________________________________ You are authorised to set up a standing order on my/our account as specified below. My/our account will at all times contain sufficient funds to enable each payment to be effected on the due date. My name: _______________________________________________________________ My address: ______________________________________________________________ My email: _______________________________________________________________ My contact Tel: ____________________________________________________________

Please charge my account:

per month

per year

Payment amount: ___________ A/C number: _____________________________ Sort code: _______________________________ Name of Account: __________________________ Commencing with first payment on (dd/mm/yyyy): _________ Signature: _____________________________________ Date: ________________________________________ Ref: HHH _____________________________________ (to be completed by Outreach Moldova)

And Pay To:

Name of Account: Bank: Branch: NSC: A/C Number:

OUTREACH MOLDOVA BANK OF IRELAND TRINITY 90 00 17 95 48 90 71

Suite 104, DMG House, Deansgrange Business Park, Deansgrange, Co. Dublin, Ireland Tel/Fax: 01-219 0268 Email: info@outrechmoldova.org Web: www.outreachmoldova.org Charity Number: 20045838 Address:


Turn static files into dynamic content formats.

Create a flipbook
Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.