If you would like to support the work of Crossroads financially, please print out this form and fill in section 1 and the other relevant sections of the form. Please return the form to the Treasurer, c/o Crossroads Project, 71 Liverpool Road, Crosby, L23 5SE.
1 NAME & ADDRESS (Please print in CAPITALS)
| Title | Initials & Surname | ||
| Address | |
||
| Tel No | Post Code | ||
2 GIFT AID DECLARATION (UK Tax Payers only)
I am a UK taxpayer - please claim back my tax from the Inland Revenue under the Gift Aid Scheme for any gifts I make to you.
| Signed | Date |
2002
|
Note: During any tax year you must pay Income tax (at any rate and in any way) at least equal to the amount of tax that we reclaim from your gifts to us during that year.
3 REGULAR DONATION
If you would like to give a small (eg £3 or £5 per month) donation to Crossroads fill in the
BANKERS STANDING ORDER FORM
| To (your bank's name) | Sort Code | ||
| Of (your bank's address) | |
Post Code | |
| Your Bank Account No | Name of Account | ||
| Please pay to HSBC, 82 Coronation Road, Crosby (Sort Code 40 29 17) for the credit of Crossroads Project (A/c No 61336053) the sum of | £ | (amount in words) | |
| on the day of 2002 and every month thereafter. | |||
| Signed | Date | 2002 | |
4 SINGLE DONATION
If you would like to make a single donation please send a cheque made payable to 'The Crossroads Project'.
5 CROSSROADS HOIMA
The Trustees have agreed that 10% of money raised from individuals will be given to support a similar project in Hoima, Uganda.
| If you do NOT want your donation to be included in this agreement please tick. |
| Signed | Date |
2002
|