One Off Donation – Support St Peter & St James Hospice

Amount*

Title*

First name*

Last name*

Phone

Email

Further details

Are you giving in memory of a loved one

Are you giving in memory of a loved one?

Loved ones name

Reason for donation

Address line 1*

Address line 2

Town/City*

County/State

Postcode*

Country*

Gift Aid

Please treat any donations I make in the future and have made in the past four years prior to the date of this declaration as Gift Aid donations unless I notify you otherwise. By ticking the box, I can confirm that I am a UK Income or Capital Gains Taxpayer and understand that if I pay less Income and/or Capital Gain tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference. I understand the charity will reclaim 25p of tax on every £1 that I have given.

Yes, add Gift Aid

By making an enquiry to find out more about the hospice and the services we offer, we believe you have a Legitimate Interest in hearing more about the work of St Peter & St James Hospice and we will use the information you have provided to keep you informed about our work. Should you wish to unsubscribe at any point, you can do so by emailing fundraising@stpjhospice.org or calling us on 01444 470710.

CAPTCHA