Help us make a difference...
£24.00 could provide plants and planters for the patient bedroom patios in our In-Patient Unit, bringing colour to their outdoor spaces. £60.00 could help provide items like beanbags or interactive equipment for our children and young people’s spaces, creating a welcoming place for young visitors. £100.00 could help fund special moments for patients and families, such as birthdays, anniversaries or celebrations, creating precious memories together during difficult times. £240.00 could contribute towards an episode of care from our multi-disciplinary team, helping to provide specialist support for a patient with complex needs in the community.
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
28
The Article is printed on recycled paper, produced from sustainable foresting.
Made with FlippingBook. PDF to flipbook with ease