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Event Event date
Mr/Mrs/Miss/Ms First name Surname
Company/Organisation/Team (if applicable)
Phone no. Age (if under 18)
Address
Postcode
Full name inc. title Full home address Postcode Gift Aid Date given
Total donation
Dr A Sample 123 Sample Street SS1 1SS 01/03/14 £20
Please sponsor me!
Shooting Star Chase would like to keep you updated with our news, events and appeals. We will not share your details with anyone else. Please tick below to let us know how you would like to be contacted.
Shooting Star Chase, Bridge House, Addlestone Road, Surrey, KT15 2UE. t 01932 823100 f 01932 858399 e [email protected] w shootingstarchase.org.uk Registered Charity No. 1042495
I’m happy for Shooting Star Chase to contact me: via mail via email via telephone via text
By providing us with personal data you consent to the terms and conditions of our privacy statement available at shootingstarchase.org.uk. You can unsubscribe at any time by getting in touch with our Supporter Care Services team on 01932 823115 or [email protected].
Full name inc. title Full home address Postcode Gift Aid Date given
Total donation
It’s really easy to pay in your sponsorship money
Post Please send a cheque with this form to Shooting Star Chase, Bridge House, Addlestone Road, Surrey, KT15 2UEPhone Call us on 01932 823100 and we can take a card paymentOnline Go to shootingstarchase.org.uk/donate
If you have any enquiries please email [email protected]
You can make your donation go further with Gift Aid
If I have ticked the box headed Gift Aid, I confirm that I am a UK income or capital gains taxpayer. I have read this statement and want Shooting Star Chase to reclaim the tax on the donation detailed above, given on the date shown. I understand that I must pay an amount of income tax and/or capital gains tax in the tax year at least equal to the amount of tax that all the charities and CASCs I donate to will reclaim on my gifts for that tax year. 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.
