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Are you interested in a group

           haemodialysis holiday in

           Majorca (Mallorca)


           in September or October?


           Diaverum have treatment
           capacity in this Spanish island.

           If you would like to express
           your interest in joining a group
           of fellow Irish patients for a
           weeks’ holiday, please email or
           phone Deborah in Head Office,
           01-6205306, by mid-April.



                      SUPPORT THE WORK OF THE IKA


                                Yes, I would like to make a regular donation by
                                                      STANDING ORDER.

                                            STANDING ORDER REQUEST FORM
          To: The Manager of
                                                  (Your bank's name and address)
          I/We hereby authorise you to set up a Standing Order on my/our account as specified below:

          Signed:                                                                                                                                          Date:
          Address:

          PLEASE CHARGE TO MY / OUR ACCOUNT:           Name of Account:

          IBAN:                                                                                                  Bank Identifier Code - BIC:
                                          (These can be found, printed on your bank statement)
          My regular          Monthly        Quarterly        Yearly       DONATION of Amount €
                              (Please tick as appropriate)
                                                                    to start on Date:          /          /
          AND CREDIT TO THE FOLLOWING ACCOUNT:
          Name of account:     IRISH KIDNEY ASSOCIATION at Bank of Ireland, College Green, Dublin 2.
          IBAN NO.:  IE06 BOFI 9000 1717 1934 35         BIC NO.:  BOFIIE2D
                                                                                                          Charity
          As long as you are a PAYE or self-employed tax payer, when you donate €250 or more in a year (€21 or more per month), the Revenue Commissioners will give  Registration
          the Irish Kidney Association CLG an extra rebate of 45%. For example, if you gave €250 in one year, the IKA would gain an extra €112, at no extra cost to you.  No. 20011260
         Please post to: THE IRISH KIDNEY ASSOCIATION CLG, DONOR HOUSE, BLOCK 43A, PARKWEST, FREEPOST, DUBLIN, D12 P5V6
                                              (PLEASE DO NOT POST TO YOUR BANK)
                             THANK YOU FOR YOUR GENEROSITY
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