One Off Donation (DO NOT UNPUBLISH)

You’re making a one-off donation of: £ 25.00

In Memory

Is this donation in memory of someone? Yes No

In memory of

They are my

Please specify

Reason for Donation e.g. Fundraiser

Would you like to leave a message regarding this donation? Yes No

Message

Your Details

Title *

First name *

Last name *

Email address *

Phone number

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County

Country

You’re making a one-off donation of: £ 25.00

Card Number*

Expires*

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If this is a personal donation, and you are a UK taxpayer the Government will give us 25p for every £1 you donate!

I want to Gift Aid my most recent donation and any donations I make in the future or have made in the past four years to CNWL NHS Health Charity. I am a UK tax payer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all of my donations in that tax year it is my responsibility to pay any difference.

The address details that you have for me are my current home address details.

Please note that for your gifts to qualify for tax relief, you need to be paying 25p in Income or Capital Gains tax for every £1 you donate.

Yes I would like you to claim Gift Aid on my donation

We'd love to keep in touch with you with news about our fundraising and events, and the impact you are making to patients and staff at CNWL. You can change any of your preferences at any time by contacting us at cnwl.charity@nhs.net.

I would like to be kept up to date with your projects and activities by the methods I choose below

SMS

Phone

I would NOT like to be kept up to date with your projects and activities by the methods I choose below

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