SATURDAY 7th APRIL 2018

APPLICATION FOR TICKETS

I wish to apply for.……tickets @ £100 each for the Champagne Reception and Concert only

I wish to apply for…….tickets @ £250 each for the Champagne Reception, Dinner (including wine) in The Orangery and Concert

I wish to apply for ….tables of 10 @ £2,500 each each for the Champagne Reception, Dinner (including wine) in the Orangery and Concert

Name of Company/Individual: ______

Address: ______

______

Postcode: ______

Email: ______

Tel: ______


I enclose a cheque for £………….payable to The Churchill Memorial Charitable Trust

Or

Please debit my credit/debit card (Visa/Mastercard/Delta/Maestro/CAF)

Card Number ☐☐☐☐☐☐☐☐☐☐☐☐☐☐☐

Security Code ☐☐☐

Expiry Date ☐☐/ ☐☐ Valid From ☐☐ / ☐☐

Maestro only: Issue No ☐☐ Security No ☐☐

Signature ……………………………………………………

Date …………………………………………………………..

GIFT AID & DECLARATION

DONATIONS

I am unable to attend but enclose a cheque for my donation towards the work of The Churchill Memorial Concerts Trust. £…………………….

TICKETS

We aim to ensure that as many people can attend the performance as possible, and have set the ticket price accordingly at a minimum payment of £100per ticket. However, in order to further to the work of The Churchill Memorial Concerts Trust, we would be grateful for any further discretionary donationsif you wish.

GIFT AID

If you are a UK taxpayer, The Churchill Memorial Concerts Trust can reclaim 25 pence for every £1 that you donate under Gift Aid. Donations include payments made in lieu of attendance, and any donations made over and above the minimum payment for tickets for the event. You need to pay enough tax in accordance with the Declaration below in order to qualify. If you are an additional or higher rate taxpayer, you may be able to claim further tax relief on your self-assessment tax return. If you pay sufficient tax, and wish to support us through gift aid please tick this box and complete the Declaration below. [ ]

DECLARATION Churchill Memorial Concerts Trust – Charity Number 1021044

Please treat as Gift Aid donations all qualifying gifts of money made today and in the future.

I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the Charities or Community Amateur Sports Clubs ('CASC') that I donate and will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand that the Charity will reclaim 25 pence of tax on every £1 that I give in accordance with this Declaration.

Donor's Details:

Title: / …………………………………………………………………………………….
First Name or Initials: / …………………………………………………………………………………….
Surname: / …………………………………………………………………………………….
Full Home Address: / …………………………………………………………………………………….
Post Code: / …………………………………………………………………………………….
Date: / …………………………………………………………………………………….
Signature / …………………………………………………………………………………….

Please notify the Charity of CASC if you:

  • Want to cancel this Declaration;
  • Change your name or home address;
  • No longer pay sufficient tax on your income and/or capital gains.

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 & Customs to adjust your tax code.

Please scan and return this form to:

Claire White -

Or print off and post to:

Claire White, 32 Herondale Avenue, London SW18 3JL

Please include your email address in all communication.

Any enquiriesshould be sent to: