USE THIS FORM FOR CASH/CHEQUE/CREDIT CARD DONATIONS ONLY
Fill in this form online, PRINT it out, click on the 'Finish' button, and send it together with your remittance to the address at the bottom of the form. DO NOT email us your credit card details.

Your Details
   
Title:
Forename:
Surname:
Address1:
Address2:
Address3:
Town:
Postcode:
Country:
Tel:

 Email:
Please tick this box if you do not wish to receive a receipt letter:

I enclose cash/cheque for  

Or please debit my    

Credit Card Number:  Expiry Date:  /  

Chip & Pin Card?


Signature: ................................................................... (credit card payments only)
Please make cheques payable to 'El Refugio del Burrito'

Send your completed form and remittance to:
El Refugio del Burrito (Adoptions),
Apartado 25,
29520 Fuente De Piedra, Málaga, Spain

Print out your completed form and then click ->