This form needs to be printed and completed and cannot be emailed direct to National Office. Please click the 'print' button above.
Title: Mr. Ms. Mrs ................... First name .........................................................
Surname:.............................................
Amount of donation ................................
Address:..............................................................................................................
.........................................................................................................................
Postcode: ....................................... Tel:............................................................
GIFT AID DECLARATION I wish LUPUS UK to treat any donations made by myself as Gift Aid donations.
Signature..........................................................................................
Date......................................................
I confirm I pay an amount of income tax and/or capital gains tax at least equal to the tax that the charity reclaims on my donations in the tax year (28p per 1)
I would also be interested in Volunteering Opportunities for LUPUS UK and/or my Regional Group (please tick)
IF WISHING TO REMIT BY STANDING ORDER, PLEASE TELEPHONE FOR THE INSTRUCTION FORM
PLEASE COMPLETE RELEVANT SECTIONS OF THIS FORM AND SEND TO: LUPUS UK, St James House, Eastern Road, Romford, Essex RM1 3NH Tel: 01708 731251 Fax: 01708 731252