Donation Application Form

I would like to donate to Al-Noor. Please find my details and commitments below: * fields required.

Details of Sponsor

Name:           *

Address1:       *

Address2:      

City/ County: *

Post Code:    *

Country:        *

Tel Office:   

Tel Home:     *

Tel Mob:      

Email:          *

I will make a Monthly Quarterly Yearly contribution

of USD GBP EUR CAD * indicate amount

starting every 1st of every month. In case of quarterly or yearly, please indicate which month and date you would like to commence payments: January February March April May June July August September October November December   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    

I undertake to donate for

1 Year 2 Years 5 Years 10 years. However should my circumstances change, I will give no less than 3 months notice, to enable Al Noor to find another donor.

I will send my contributions to the following account:

Barclays Bank, 36-38 Park Royal Rd, London NW10 7JA, UK. Sort Code 20-92-60, acc No 73964795           account name: Al Noor Society

HSBC 51A Dharmapala Mawatha, Colombo 03, Sri Lanka.       SWIFT: HSBCLKLX, acc No 003-009990-001 account name: Al Noor.

I will use my name as reference against my contributions. (This is to help us track payments).

Al Noor will send you an email confirming receipt of your donation on cleared funds. Please note where ever possible we will email rather than post. This is to reduce unnecessary expenses. However, if you wish an official receipt, please state in the comments box below.

Typing your name here will be taken as equivalent to your signature:

Date:       *

If you wish to add any comments, please do so below.



Thank you for supporting Al Noor!