St Leonard's Hospice

Step 1.

I'd like to donate *Monthly Annually

I would like to donate *

£2 £5 £10

or

£

All Donations are via Direct Debit View Direct Debit Guarantee

Step 2.

Add 25p for every £1 you give – at no extra cost to you! It only takes a tick!

Yes

Thank you for Gift Aid!

Choosing to Gift Aid your donation means we will now receive an additional £1.25 from HM Revenue and Customs at no extra cost to you.

I want to Gift Aid my donations to St Leonard’s Hospice, including any I make in the future, or have made in the past four years until I notify you otherwise. I am a UK taxpayer and I understand that, in any tax year, if the total of my Income Tax and Capital Gains Tax due is less than the amount of Gift Aid claimed on all my donations, it is my responsibility to declare this to HMRC

Step 3.

Title *

First name *

Surname *

Date of Birth

Email address *

Verify email address *

Telephone number*

Mobile number

Address 1

Address line 2

Address line 3

Address line 4

Town

County

Post code*

Please tick if you are 16 or under

Step 4.

Please let us know what’s inspired you to support St Leonard’s Hospice so generously

Step 5.

We would love to stay in touch with you as we build our future so we can keep you updated on our work, events and fundraising activities.

If you're 16 or under, we can still keep you updated but need your parent/guardian's permission. We will post you a form for them to sign.

Are you happy for us to contact you by email?

Yes

We may also contact you occasionally by post and / or telephone, unless you tell us you don't want these communications, which you can do so here:

Please don't contact me by postPlease don't contact me by phone

Regular Giving