Help us make a difference... £20.00 could provide Kodak photo paper for our printer, allowing patients to create lasting memories by having photos taken with their loved ones during their stay. £50.00 could contribute towards an evening complementary therapy session in our In-Patient Unit, helping a patient relax and settle for a more restful sleep. £100.00 could help support haircare services in our on-site hairdressing salon for the week, offering patients comfort and a boost to their well-being during their stay in our In-Patient Unit.
£150.00 could help provide a wheelchair for use at any of the Living Well Hubs, ensuring accessibility and comfort for all participants during their sessions.
My own choice of
My own choice of £
Your details
Name: Address: Postcode:
Contact no:
I enclose a cheque made payable to Ayrshire Hospice or please debit my:
Maestro only
Card number
Valid from Expiry date Security code
Visa Mastercard
Issue no (Maestro only)
(last 3 digits on the back of your card)
Maestro Delta
Signed by:
Date:
Gift Aid your donation! It will boost your donation by 25p for every £1 you donate. Gift Aid is reclaimed by Ayrshire Hospice from the tax you pay for the current tax year. Your address is needed to allow us to identify you as a current UK taxpayer. In order to Gift Aid your donation, you must tick the box below: I want to Gift Aid any donations I make in the future or have made in the past 4 years to Ayrshire Hospice. I am a UK taxpayer and 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 notify us if you want to cancel this declaration, change your name or home address or no longer pay sufficient tax on your income and/or capital gains. If you pay Income 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 & Customs to adjust your tax code.
Please return this donation form to our Fundraising Office at 29 Miller Road, Ayr, KA7 2AX. Thank you for your support! Please return this donation form to our Fundraising Office at 35-37 Racecourse Road, Ayr, KA7 2TG. Thank you for your support!
Registered Scottish Charity No: SC011390
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