Name of Participant:

Address:

Postcode:Date of Birth:

Telephone Contact: Email:

Bethany Christian Trust has been working with homeless and vulnerable people in Scotlandsince 1983 and is a registered charity (no. SC003783). Any funds that you contribute will go directly to help the work of the Trust. For further information on this event and the work of Bethany ring 0131 561 8925 or visit

DONOR

/

DONATION

Full Name

/

Home Address & Postcode

(For us to reclaim tax you must clearly print your name, address & postcode) /

Amount

Pledged /

Amount

Given

/

Date

Given

/ Gift Aid? ()*
Total amount carried over
/ £

* Gift Aid Declaration:
By ticking this column 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 (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 25p of tax on every £1 that I give.
Name of Participant:

DONOR

/

DONATION

Full Name

/

Home Address & Postcode

/

Amount

Pledged /

Amount

Given /

Date

Given / Gift Aid? ()*
Total Amount Raised
/ £

* Gift Aid Declaration:
By ticking this column 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 (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 25p of tax on every £1 that I give.

Please make cheques and postal orders payable to ‘Bethany Christian Trust’ and forward your sponsor money with your sponsor form to Bethany Christian Trust, 65 Bonnington Road, Edinburgh, EH6 5JQ by 16May 2016. You can also hand money in to any of our shops, in an envelope, clearly marked “Big Sleepout 2016” with your name and address.