Patron Application Form (Euro)

Print and complete this form, then return it to the Temple (forms can be put in the donation box in the Temple room)

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EURO Donation Form

International Society for Krishna Consciousness Founder – Acarya His Divine Grace A.C. Bhaktivedanta Swami Prabhupada

Inis Rath Island Derrylin Co. Fermanagh N.Ireland, BT92 9GN. 028 67723878 (048 67723878 from Ireland)
Charity no. XN79215        www.krishnaisland.com

Become A Hare Krishna Island Patron

You can contribute by standing order any of the following amounts, or other amount of your choice:

Mandir Benefactor       €108 up to €1008 per month
Mandir Sponsor                   €51 up to €107 per month
Mandir Donor                         €25 up to €50 per month

Standing Order Request Form – For Euro Currency Donations

Please make standing order payments to: Ulster Bank, Ballyconnell, Co. Cavan

Account Name: ISKCON (NI)

Sort Code, 98-52-60 Account Number: 06482050

Beneficiary reference: Temple Patron [on the first day of each month, starting this month]

Your Surname …………………………………………………….

Your First Name(s) ………………………………………………………

Address ……………………………………………………………………………………………

……………………………………………………………………………………………………….

……………………………………………………………………………………………………….

Your Bank name ………………………………………………………………………………..

Bank Location …………………………………………………………………………………..

Your Account Number ……………………………………………………………………….

Sort Code ………………………………………

Amount  of Contribution  € …………………………….. per month.

Signed ……………………………………………………………………………….

Date ………………………………………………