One Off Donation Form

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Yes, I wish to give a one-off donation to Wirral Donate
and for the gift to be credited with Gift Aid (if applicable).

Surname:............................................................. Initial/s:........................

Title: Mr, Mrs, Miss, Ms (please delete)

Home address: ........................................................................................

................................................................................................................

Post Code:......................................Tel No:..............................................

Email:.....................................................................................................

I enclose a cheque to the value of:

In Words ……………………..……….....…. In figures: £…..........………..

Gift Aid Declaration (for Inland Revenue)

If you are a tax payer and would like your donation to be boosted by
Gift Aid paid direct to Wirral Donate please sign the declaration below.

I confirm that I am a tax payer and would like my donation to be credited with gift aid:

Signed:……………..........……….

 

Please photocopy this form and send a copy to your bank
and the original form to Wirral Donate at this address:

Mr R Collings (Secretary to Wirral Donate)

Devonshire Resource Centre
141 Park Road North
Birkenhead
CH41 0DD

 

For the purposes of the Data Protection Act 1998

The data supplied on this form will be used to enable your donation to reach
your chosen charity, Wirral Donate. In order that your instructions can be
acted on, your details will be passed to Her Majesty’s Revenue & Customs,
who will forward the Gift Aid of your donation to Wirral Donate.

Wirral Donate may send you a thank you letter acknowledging your donation.
If you do not wish to receive acknowledgement from your charity and only wish
to be contacted in the event of a specific query needed to resolve the processing
of your data for the purposes of these instructions, please tick here: