Full Name *

First Name

Last Name

Please check and agree to the following: *

I confirm that I want to Gift Aid the donation detailed below, as well as any donations I make in the future or have since 6th March 2015 to Maxability.

Full Postal Address *

Address 1

Address 2

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Zip/Postal Code

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Date of donation

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Please check and agree to the following: *

I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations, it is my responsibility to pay any difference.

Full Name *

First Name

Last Name

Please check and agree to the following: *

I confirm that I want to Gift Aid the donation detailed below, as well as any donations I make in the future or have since 6th March 2015 to Maxability.

Full Postal Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of donation

MM

DD

YYYY

Please check and agree to the following: *

I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations, it is my responsibility to pay any difference.