Donation Details

Your donation amount * €

Frequency * Monthly Quarterly

Payment day * Select... 1st of the month 15th of the month

Existing Supporter Number
(if known)

What prompted you to donate to
Sightsavers today? Select... TV Ad Friend or Family Press Ad Leaflet in a Newspaper Radio Ad Mailing Internet Search Engine Online Advertisement Email Other Unknown

Personal Information

Title *

First Name *

Surname *

Email *

I would like Sightsavers to keep me up to date

Address 1 *

Address 2

Town *

County * Select.. Co AntrimCo ArmaghCo CarlowCo CavanCo ClareCo CorkCo DerryCo DonegalCo DownCo DublinCo FermanaghCo GalwayCo KerryCo KildareCo KilkennyCo LaoisCo LeitrimCo LimerickCo LongfordCo LouthCo MayoCo MeathCo MonaghanCo OffalyCo RoscommonCo SligoCo TipperaryCo TyroneCo WaterfordCo WestmeathCo WexfordCo Wicklow

Country Ireland

Contact Preferences

Phone

Mobile

You can change the way we contact you at anytime, just let us know

I would like to receive updates by post
I would like to receive updates by phone
I would like to receive updates by SMS

Direct Debit

Account Holder Name(s) *

Bank Name *

Bank Address *

Town *

County * Select.. Co AntrimCo ArmaghCo CarlowCo CavanCo ClareCo CorkCo DerryCo DonegalCo DownCo DublinCo FermanaghCo GalwayCo KerryCo KildareCo KilkennyCo LaoisCo LeitrimCo LimerickCo LongfordCo LouthCo MayoCo MeathCo MonaghanCo OffalyCo RoscommonCo SligoCo TipperaryCo TyroneCo WaterfordCo WestmeathCo WexfordCo Wicklow

Branch Sort Code (6 char) *

Account Number (8 char) *

Taxback

If you are a PAYE tax payer please help us reclaim tax on your donation by selecting one of the following.

Select... Not a Tax Payer Standard Rate Tax Payer Higher Rate Tax Payer Self Assesseed for Tax