Donations | Pursue

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Name *

First name

Last name

Address

House name or number

Address line 1

Address line 2

Address line 3

Address line 4

City

County

Postcode

Country

Email address

Phone Number

Amount

£

Recurring period *

First payment date *

Gift Aid?

By ticking this box I confirm that I am a UK Income or Capital Gains taxpayer. I have read this statement and want the charity to reclaim tax on the donation detailed on this form, given on this date. I understand that if I pay less Income Tax / or Capital Gains tax in the current tax year than the amount of Gift Aid claimed on all of my donations it is my responsibility to pay any difference. I understand the charity will reclaim 25p of tax on every £1 that I have given.

Total amount

£

Pay processing fee

£

Donation *

Debit / Credit Card

Cheque
Make cheque payable to
Pursue

Send to
Kent Cottage,
Mill Lane,
Stratford-Sub-Castle
Salisbury
SP1 3LJ

BACS and Online Transfer
Make deposit to account
Sort Code: 16-58-10 Account Number: 21358486

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