spinathon sponsor form
DESCRIPTION
Action Medical Research Form for 7th May Spinathon 2011TRANSCRIPT
Did you know - If you are a UK tax payer wecan claim tax back on your donation.We who have given our names and addresses below, andwho have ticked the box entitled Gift Aid want ActionMedical Research to reclaim tax on the donation detailedbelow, given on the date shown. We understand that eachof us must pay income tax or capital gains tax equal to thetax reclaimed by the charity on the donation.
If you run out of room for names don’t worry, photocopies of this side of the form will be accepted
Participant’ s name
Event Date
Address
Postcode
Action Medical Research registered office: Vincent House, Horsham, West Sussex RH12 2DP
T 01403 210406 F 01403 210541 E [email protected] www.action.org.uk
Full name Amount given
Date given(dd/mm/yy)
Sub total £
Housenumber
Postcode Amount pledged
GiftAid 3
Paying in
slip No.
Sponsorship form
Challenge events
Please help us to fund the next medical breakthrough for children
Help stop the suffering of children caused by disease and disability
SPINATHON - ACTION MEDICAL RESEARCH 07/05/2011
Total amount raised £
Please return this form to:
Action Medical Research
Challenge eventsVincent House
Horsham
West Sussex RH12 2DP
Please make cheques payable to Action Medical Research
Office use only:
Amount received £ . . . . . . . . . . . . . . . . . . . . . . . .
Date banked . . . . . . . . . . . . . . . . . . . . . . . . . .
Paying-in slip ref. . . . . . . . . . . . . . . . . . . . . . . . . . .
Full name Amount given
Date given(dd/mm/yy)
Housenumber
Postcode Amount pledged
GiftAid 3
Paying in
slip No.