Good Childhood Memories Last a Lifetime

Good childhood memories last a lifetime

Title: ______First Name: ______

Address: ______

Tel: ______Email: ______

Signature: ______Date: ______

I would like to make a regular donation of:

£5 £10 £25 £50 £100 or £_____

Per week month quarter year starting: ____/______/______

Bank name: ______

Bank address: ______

______Postcode: ______

Sort Code: ____-_____-_____ Account number: ______

Bank instructions: to the Royal Bank of Scotland, 12 North-West Circus Place, Edinburgh, EH3 6SX

Account name: Hopscotch Children’s Charity Account number: 00138231 Sort Code: 83-20-02

I am pleased to enclose a single donation of:

£5 £10 £25 £50 £100 £250 £500 £1,000 or £______

Cash Cheque CAF cheque

Please make cheques payable to HopScotch Children’s Charity

Please send your completed form to:

HopScotch Children’s Charity

42 Silverknowes Road

Edinburgh

EH4 3PG

______

Gift Aid Declaration: If you’re a UK tax payer * your donation could be worth 20% more under the Gift Aid scheme. Just tick this box

* I am a UK tax payer and I would like HopScotch to treat all donations I have made for the four years prior to this year, and all donations I make from the date of this declaration until I notify otherwise, as Gift Aid donations. To qualify for Gift Aid what you pay in income tax or capital gains tax must equal the amount we will reclaim in the tax year. Higher rate payers can claim the difference between basic and higher rate tax on their tax return. For us to be able to process your Gift Aid claim, we need to keep these details on file. In line with the Data Protection Act, we need to ask your permission to be able to do this. We treat all personal information with respect and never sell or pass on data. If you do not wish your details to be kept on file, please tick here