Donation Form

MY DONATION

I am making a single donation of*

£

This donation is

a personal donation

on behalf of a company or organisation

paying in my sponsorship or fundraising money

And is

a general donation

in memory of someone

for a special occasion

for a fundraising event or sponsorship

We're unable to claim Gift Aid on collections or donations from groups

MY DONATION IS ON BEHALF OF A COMPANY OR ORGANISATION

a general donation

in memory of someone

for a special occasion

to sponsor or support a fundraising event

We're unable to claim Gift Aid on collections or donations from groups

Event name

Thank you so much or fundraising for us. Please add any further details you wish, and let us know if you are fundraising in memory of someone: Do send us any paper sponsor forms so we can claim any Gift Aid due.

THANK YOU FOR YOUR DONATION

GIFT AID *

With Gift Aid your donation would be worth 25% more - at no cost to you. Gift Aid of 25p for every £1 you donate can be reclaimed by the charity from the tax you pay in the corresponding tax year.

Yes, I would like to Gift Aid this donation and any donations I make in the future or have made in the last four years to Epilepsy Research UK. 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. This is a personal donation. It does not include funds from anyone else, or the proceeds of a collection or fundraising event. Epilepsy Research UK will reclaim 25p for every £1 you donate from the tax you pay in the corresponding tax year. Please let us know if your name or address changes, if you cease to be a taxpayer or if you wish to cancel this declaration.

No, I do not wish to Gift Aid this donation.

MY DONATION IS IN MEMORY OF

GIFT AID *

With Gift Aid your donation would be worth 25% more - at no cost to you. Gift Aid of 25p for every £1 you donate can be reclaimed by the charity from the tax you pay in the corresponding tax year.

Yes, I would like to Gift Aid this donation and any donations I make in the future or have made in the last four years to Epilepsy Research UK. 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. This is a personal donation. It does not include funds from anyone else, or the proceeds of a collection or fundraising event. Epilepsy Research UK will reclaim 25p for every £1 you donate from the tax you pay in the corresponding tax year. Please let us know if your name or address changes, if you cease to be a taxpayer or if you wish to cancel this declaration.

No, I do not wish to Gift Aid this donation.

NAME OF PERSON OR OCCASION YOUR DONATION IS SUPPORTING

GIFT AID *

With Gift Aid your donation would be worth 25% more - at no cost to you. Gift Aid of 25p for every £1 you donate can be reclaimed by the charity from the tax you pay in the corresponding tax year.

Yes, I would like to Gift Aid this donation and any donations I make in the future or have made in the last four years to Epilepsy Research UK. 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. This is a personal donation. It does not include funds from anyone else, or the proceeds of a collection or fundraising event. Epilepsy Research UK will reclaim 25p for every £1 you donate from the tax you pay in the corresponding tax year. Please let us know if your name or address changes, if you cease to be a taxpayer or if you wish to cancel this declaration.

No, I do not wish to Gift Aid this donation.

NAME OF PERSON OR OCCASION YOUR DONATION IS SUPPORTING

THANK YOU FOR YOUR DONATION

MY DONATION IS IN MEMORY OF

NAME OF PERSON OR OCCASION YOUR DONATION IS SUPPORTING

NAME OF PERSON OR EVENT YOU ARE SUPPORTING

STEP 1 OF 3

MY DONATION

This donation is

And is

MY DONATION IS ON BEHALF OF A COMPANY OR ORGANISATION

Event name

With Gift Aid your donation would be worth 25% more - at no cost to you. Gift Aid of 25p for every £1 you donate can be reclaimed by the charity from the tax you pay in the corresponding tax year.

With Gift Aid your donation would be worth 25% more - at no cost to you. Gift Aid of 25p for every £1 you donate can be reclaimed by the charity from the tax you pay in the corresponding tax year.

With Gift Aid your donation would be worth 25% more - at no cost to you. Gift Aid of 25p for every £1 you donate can be reclaimed by the charity from the tax you pay in the corresponding tax year.

Thank you for being part of this powerful community working together to achieve a life free from epilepsy.