DIRECT DEBIT DONATION FORM
OUR APPROACH:
Please fill in the whole form and send it to: Self Help Africa, Westgate House, Hills Lane, Shrewsbury SY1 1QU
I WOULD LIKE TO MAKE A REGULAR DONATION TO SELF HELP AFRICA
Sub-Saharan Africa is the poorest region in the world. £8
Close to 70% of its people rely on small farms for their survival. Inadequate farming practices, hand tools, harsh climates and lack of support mean that most farms produce just a fraction of their potential.
£12
monthly
£20
other £
quarterly
starting on the 17 of
annually (month)
th
Instruction to Bank/Building Society Name and address of your Bank/Building Society To: The manager
We want to change that.
Bank/Building Society
Address
Increasing yields, diversifying crops, better farming practices, access to credit, gender equality, and assistance with enterprise creation are vital to ending poverty in Africa.
Postcode Name(s) of Account Holder(s)
Bank/Building Society Account Number
AGRICULTURE & NUTRITION
COOPERATIVES
Over 70% of Africa’s poorest people live on small farms with potential to grow much more.
Working together as a cooperative means farmers can access new markets and earn a better income from their produce.
GENDER
MICROFINANCE
Women do most of the work, yet receive only a fraction of the available support. If women received the same support, yields would increase 20–30%.
Microfinance projects give impoverished rural families access to small loans to improve their farms, so they can grow, eat and sell more.
CLIMATE CHANGE
ENTERPRISE
The people least responsible for climate change are those who are most affected by global warming.
Small businesses enable households to earn a vital alternative source of income that allows them to send children to school and more.
Branch Sort Code
Service User Number
4
3
0
0
1
5
Reference (to be completed by Self Help Africa)
Instruction to your Bank or Building Society to pay by Direct Debit: Please pay Self Help Africa (UK) Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with Self Help Africa (UK) and, if so, details will be passed electronically to my Bank/Building Society. Signature(s)
Date
A Gift Aid declaration allows Self Help Africa to claim an extra 25p for every £1 you give. By ticking this box, I confirm that I am a UK taxpayer and would like Self Help Africa to claim back the tax on this donation and any donations I make in future, or have made in the past four years. I understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.
PLEASE COMPLETE THE REVERSE OF THIS FORM