Order Form

‘Yes we can – together’

Hampden Park Quilt Project

View the quilts –

Quilt order form – all quilts will be posted after the event at Hampden has taken place

Name………………………………………..Surname…………………………………………………….

Address……………………………………………………………………………………………………..

Postcode…………………..

Contact Number……………………………………………

I would like a specific/any quilt (please delete as appropriate)

Quilt Number from website (if known)…………………………………………………………………

THE VALUE OF THE QUILTS: Quilts are expensive and take a great amount of time to make. Fabric for a lap quilt costs £40, for a single bed quilt - £80 and a double bed quilt costs £160 for the fabrics alone.

You might consider a minimum donation of £20 for a lap, £40 for a single and £80 for a double bed quilt.

Donation (all donations exclude P&P) £………………………………………………..

P&P £6.95(for return of quilts to the address above)

Total (donation +P&P) £…………………………………. (gift aid, please see over page)

Payment type (please circle) credit or debit card/ cheque/ cash

Card number…………………………………….. Card type (circle)visa/debit/mastercard/maestro

CSI code (last three digits on back of card)…………………………

Exp date…………………………………… Start date………………………..

Please make all cheques payable to Alzheimer Scotland and send all forms and monies to the address below:

Rachel Laming, Fundraiser

Alzheimer Scotland

49 Milngavie Road

Glasgow, G61 2DW

0141 946 0966 or 07879 551 831

Please tick this box if you would like to hear more about the work of Alzheimer Scotland

Please tick this box if you would like to hear more about the Hampden Quilt Challenge

Gift Aid

As you are essentially buying the quilt your donation is not eligible for GIFT AID on this occasion. However if you would like to make a further donation to this project and are eligible to claim gift aid please do so below.

Please read the information below and sign as appropriate:

I would like to make a donation of £………………………. and have enclosed cheque/bank details.

I am a UK tax payer and would like Alzheimer Scotland to treat all donations I have made in the past 4 years and all my future donations as Gift Aid donations.

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 charities or Community Amateur Sports Clubs (CASCs) that I donate to 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 the charity will reclaim 28p of tax on every £1 that I gave up to 5 April 2008 and will reclaim 25p of tax on every £1 that I give on or after 6 April 2008.

I understand that my details will be kept on a database for administration and fundraising purposes.

Signed:……………………………. Dated:…………………………..

Name:…………………………………………….