Please treat as Gift Aid donations all qualifying gifts of money made:

TodayIn the past 4 yearsIn the future

Please tick all boxes you wish to apply

I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year, it is my responsibility to pay any difference.

Title:

First name:

Last name:

Address line 1 :

Address line 2 :

City or Town:

Post Code:

Your email:

Phone number:

Date:

Please notify the charity if you:

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code

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