THE HOSPICE IN THE VALE OF BELVOIR

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I belong to a group which may be interested in holding a fund- raising event.

I belong to a group which would like a speaker to talk about Dove Cottage.

I would be interested to hear more about becoming a volunteer.

I enclose a gift of £..............

I would like to become a "Regular Giver to Dove Cottage" and enclose my first subscription of       £..........

......I would like to contribute this amount

ANNUALLY ...........................QUARTERLY ...............................MONTHLY

I have completed the standing order form which forms part of this page.

I pay Income Tax (Please complete the Gift Aid form,this will increase your donation to us at no       extra cost to you.

I would like to make a one-off gift.(Please complete the Gift Aid form if you are a tax payer, this will       increase your donation to us at no extra cost to you.

I have completed the Gift Aid form at tbe bottom of this form.

 

NAME:................................................

ADDRESS:................................................................................................

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

......................................................POSTCODE.......................................

TELEPHONE No:....................................................................................

Please make your cheque payable to "DOVE COTTAGE DAY HOSPICE" and return,with this form to Dove Cottage Day Hospice, FREEPOST MID20970, Leicestershire LE14 2BR

We will, from time to time,send you details of Dove Cottage events and developments, but your name and address details will not be passed on to any other organisation.

STANDING ORDER

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BLOCK CAPITALS PLEASE...............................................................(please delete as applicable)

To.......................................................................................................................................Bank Plc

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

Bank Sort Code

Please pay Lloyds Bank Plc,High Street,Melton Mowbray,Leics LE13 OTS
(sort Code 30-95-52)for the account of DOVE COTTAGE DAY HOSPICE,
Account No 0262758.

From my Account:....................................................................

The Sum of ...........................................................................(in words)...£....................(in figures).

on ..............................(day) ...........of .......................................................(month).............(year)

*and monthly/quarterly until further notice.

Signature..........................................................................................................Date.........................................

Address...............................................................................................................................................

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

.........................................................................................................................Post Code...................

For Bank use:
Quote this Dove Cottage reference on transactions -(Our ref.....................................)

 

 

 

 

 

 

 

GIFT AID FORM

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GIFT AID DECLARATION

Yes- I would like the Inland Revenue to make every £1 donation worth £1.28

Title (Mr,Mrs etc)                  Forename                                                     Surname

_______________                   _______________________                          _______________________

Address

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Post Code                                  Telephone Number

__________________                  _____________________________

I authorise Dove Cottage Day Hospice to treat all donations I have made since the 6th April 2000 and any future donations, as Gift Aid donations until further notice.

I am a U.K. tax payer.

Signed______________________                             Date _______________

Thank you for your support

If you are unsure whether your donations qualify for Gift Aid , please obtain a copy of leaflet IR64 Giving to charity Individuals by the Inland Revenue.

 

 

 

 

 

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