The Dougie Mac Sponsor Forms The Dougie Mac Sponsor Forms | страница 2

If you are a UK tax payer, we can claim an extra 25p for every
pound you donate at no extra cost to you. Just sign below
Date

01.01.14

Title

First
Name

Your House
Number

Your
Post Code

Amount

Anne

Mrs

Last
Name
Other

161

ST1 2AB

£ 5.oo

Data Protection: Thank you for sponsoring a Dougie Mac Fundraiser. To enable
us to claim Gift Aid we require your full name, home address and postcode, the
details you provide will not be used for any other purpose.

Total
Raised

Details of the fundraiser
Title

Gift Aid

Paid

(Please treat as Gift Aid)

A Nother

3

£

How to get your donations back to the Hospice:
The donations you have raised should be collected
and returned with the sponsorship form within 4 weeks
of fundraising. Please Note: Gift Aid cannot be
reclaimed by the hospice from the Inland Revenue
without the original sponsor forms.

First Name

Last Name

Online: You can also pay in your donations online via
our website www.dmhospice.org.uk But don't forget to
post back your sponsor form to the address listed
below

Address

By post: Send your cheque(s) made payable to
‘Douglas Macmillan Hospice’ along with your paying
in forms and/or sponsor forms to Fundraising Dept,
Douglas Macmillan Hospice, Blurton, Staffordshire,
ST3 3NZ.

Postcode
Tel
Mobile

In person: You are welcome to bring in your donation
into the Hospice, or to any of our Douglas Macmillan
Hospice shops.

Email

The personal data you have given, will be used to process your payment/donation(s) and facilitate communications with you regarding this form of support for the Hospice. We will not share your information with any external organisation. We would
like to contact you with information about how we use all contributions for the benefit of local people and other ways to help. However, if you do not want to hear from us in this way we will not contact you if you tick this box n

Thank you for supporting Douglas Macmillan Hospice
Douglas Macmillan Hospice, Barlaston Road, Stoke-on-Trent, ST3 3NZ W: www.dmhospice.org.uk T: 01782 344304
FOR OFFICE Gift Aid
Total
USE ONLY

£

Non Gift
Aid Total

£

Grand
Total

£

Source
Code

App
Code

Donor
No

Pledge
No