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Surname
123 Street, London
Home address
(we can only claim Gift Aid if you supply
your house number and postcode)
AB1 2BD
Postcode
Total
£20
Sponsor
amount
01/06/2015
Date Paid
Gift
Aid?*
()
If you require further sponsorship
forms please photocopy this sheet
or call 0300 330 5452.
£50 funds the chemicals and
consumables required for a PhD
researcher to continue vital research
into understanding the causes of
dementia, how it can be treated and,
ultimately, to find a cure.
£30 allows a person with dementia to
attend weekly Dementia Café sessions
for a month where they can meet
others, share experiences and feel less
isolated.
£10 pays for someone with dementia
to enjoy a Singing for the Brain®
session, boosting their confidence and
well-being.
See what your money can do
*I am happy for all gifts of money that I have made to Alzheimer’s Society in the past 4 years and all future gifts of money that I make to be Gift Aid donations. I pay an amount of income tax and/or capital
gains tax in each tax year that is at least equal to the tax claimed by all charities and CASCs from HM Revenue & Customs on all my Gift Aid donations(s) (VAT and Council tax do not apply).
Brown
Jane
Ms
First name/
Initials
Title
Dept code:
Source code:
Supporter name:
Supporter number:
Every £1 you give could be worth 25p more*. Simply tick the box and ensure each donor handwrites their full name, home
address, postcode and date paid. Please note donor details must be completed in donor’s own handwriting and each section
fully completed to qualify for Gift Aid. We cannot claim Gift Aid on work addresses.
Reminde
r!
Make a
photoco
py
of this
form
before
using it
Jane
Ms
Brown
Surname
Don’t forget to Gift Aid
your donation and make
each £1 worth an extra 25p
123 Street, London
Home address
(we can only claim Gift Aid if you supply
your house number and postcode)
AB1 2BD
Postcode
Total
£20
Sponsor
amount
01/06/2015
Date Paid
Gift
Aid?*
()
Thank you.
For more details on how to
pay your money in, check your
electronic online fundraising
guide or our website
memorywalk.org.uk
Alzheimer’s Society operates in England, Wales and Northern Ireland. Registered charity no.296645
*I am happy for all gifts of money that I have made to Alzheimer’s Society in the past 4 years and all future gifts of money that I make to be Gift Aid donations. I pay an amount of income tax and/or capital
gains tax in each tax year that is at least equal to the tax claimed by all charities and CASCs from HM Revenue & Customs on all my Gift Aid donations(s) (VAT and Council tax do not apply).
First name/
Initials
Title
MW spons form- Wesham.pdf (PDF, 88.2 KB)
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