Ukrainian Bursary Appeal Gift Form

Ukrainian Bursary Appeal Donation Form Personal Details Title:

First Name:

Gift Aid Declaration Surname:

(Please complete this section if you are a UK taxpayer) If you are a UK taxpayer, we can reclaim tax on your donations of 25p for every £1, at no further cost to you.

(Please sign and date below)

Address:

Post Code:

Telephone:

Email: Please complete your email address if you are happy for us to contact you in this

My Gift Ukrainian Bursary Appeal. or I would like my gift to support (please specify project or department)

Donor Acknowledgement Roedean School would like to acknowledge donors in published materials and online. Please let us know how you would like your name(s) to appear:

I would like Roedean School to reclaim tax on all donations that I have made in the past four years and all future donations, until I notify you otherwise: Signature:

Date:

I confirm that I have paid or will pay an amount of Income Tax and/ or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 28p of tax on every £1 that I gave up to 5 April 2008 and will reclaim 25p of tax on every £1 that I give on or after 6 April 2008.

Please notify Roedean School if you want to cancel this declaration, if you wish to change you address or if you no longer pay sufficient tax on your income and/ or capital gains.

If you pay tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.

I wish to remain anonymous.

Data Protection: Information provided will be held securely by Roedean School Alumnae Relations and Development Office, and used for effective postal, e-mail and telephone communications with donors and supporters. This will include publications, invitations to events, and information about the school and its activities. Information will not be disclosed to any third party, other than those acting as agents for the Alumnae Relations and Development Office. If you do not want your information to be used in this way, please contact the Alumnae Relations and Development Office on 01273 667398, or e-mail mta@roedean.co.uk.

Ukrainian Bursary Appeal – Monthly Options

Ukrainian Bursary Single Gift

I would like to sponsor the Ukrainian Bursary Appeal to the monthly sum of:

I wish to make a single gift by:

£417

£208

£104

£52

Cheque (please make cheque payable to Roedean School)

£21 £

Ukrainian Bursary Regular Gift I wish to make a regular gift to Roedean School by Standing Order.

(Please complete the form below) Instruction to your Bank or Building Society to pay by Standing Order: Bank Name:

Credit/debit card (please complete the form below) I authorise you to debit my account with the sum of £ Card Type: Cardholder’s Name: Account Number:

Bank Address: Account Number:

Start Date:

Expiry Date:

Sort Code:

Issue Number:

Security Number:

Account Name:

Signature:

Please pay: Roedean School, National Westminster Bank, Castle Square, Brighton.

Sort Code: 60-30-09 The Sum of:

Account Number: 33237417

Date:

£

Amount in words: Every:

Month / Year (please specify frequency)

Beginning on:

(date) until further notice

OR until:

payments have been made.

Signature:

Date:

Please do not send this form to your bank.

Further Details I would like to: Receive information about other ways of giving.

Have a confidential discussion with the Development Office.

Receive information about remembering Roedean School in my will.

Please return this form to: The Development Office, Roedean School, Roedean Way, Brighton. BN2 5RQ.

T: +44 (0) 1273 667398 www.roedean.co.uk glc@roedean.co.uk

Thank You