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Safe Haven form

Your details

Are you aged 18 or over

Membership details

Are you taking out Safe Haven membership

Membership plaque

All Safe Haven sponsors can have a name added to our Safe Haven wall by the entrance. Please complete the section below with the name that you would like to appear on the plaque. Many sponsors dedicate their plaque to a loved one.

Sponsorship details

Safe Haven sponsorship starts from just £3/month (£36/year) but we gladly accept whatever you are able to donate. Please indicate below how much you would like to contribute each month, then please complete the Standing Order section below. Thank you.

Contribution amount

Standing order

Instruction to your bank or building society to pay by Standing Order. Please complete your bank details below:

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Gift aid

If you’re a UK taxpayer, please allow the RSPCA Lancashire East Branch to boost your donation by 25p for every £1 you donate at no extra cost.


To Gift Aid your donations you must tick the box below.

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Gift Aid cannot be claimed on legacies, collections or company donations. Please let us know if your tax circumstances or name and address details change so we can amend our records.

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