Drought Relief Donor Form

Drought Relief Donation Form
This drought relief initiative is an effort by the WRSA Foundation, a non-profit company, to coordinate critical relief to private game ranches, game reserves, and their communities impacted by drought conditions.

The priority of this initiative is to assist ranches and reserves to sustain their surviving herds over the next few months.
ALL INFORMATION WILL BE TREATED AS STRICTLY CONFIDENTIAL.
YesNo
YesNo
Kindly provide the following information, where available/applicable:
Full Name*

First NameLast Name
Company Name (If Applicable)
Cellphone*
Format: 000 000 0000.
Landline
Please enter a valid phone number.Format: 000 000 0000.
E-mail*
example@example.com
Kindly indicate what type of relief you can donate:
Cash donationSupplementsFeedTransport for feed and supplementsVeterinary assistanceWater provision resourcesOther
Cash Donation
Direct paymentPayfast
Bank Account details:

Account: WRSA FOUNDATION NPC

Bank: ABSA Bank

Branch Code: 632 005

Cheque account no: 410-319-6934

Swift Code: ABSA ZA JJ

Payment Reference: Drought

Email proof of payment to accounts@wrsa.co.za
PayFast payment

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ZARThe PayFast portal will load after you click submit on the Drought Relief Donor Form.
Supplements
Please provide details of feed/supplements donation(s) here:
YesNo
Feed
Please provide details of feed/supplements donation(s) here:
YesNo
Transport
Please provide details of Transport donation(s) here:
Veterinary assistance
Please provide details of Veterinary Assistance donation(s) here:
Water Provision resources
Please provide details of Water Provision donation(s) here:
Other Donations
Please provide details of Other donation(s) here:
Invoice Information

Please provide the following information if you require an invoice for the donation:
Name of Company
VAT No (If applicable)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of contact person*

First NameLast Name
Email of contact person*
example@example.com
Contact number
Please enter a valid phone number.Format: (000) 000-0000.
On the WRSA website Foundation PageOn the WRSA Foundation Facebook & Instagram PagesNone
Any additional comments:
Thank you!

All contributions will be welcomed, appreciated, and will make a difference!
Should be Empty:

Drought Relief Donation Form

Kindly provide the following information, where available/applicable:

Kindly indicate what type of relief you can donate:

Cash Donation

Supplements

Feed

Transport

Veterinary assistance

Water Provision resources

Other Donations

Invoice Information

Thank you!