I would like to dedicate a ‘Tender Loving Care’ rose to someone special today. In loving memory of: Name:
Relationship to you:
Name:
Relationship to you:
STEP 1: Your details: Title: Address:
Name:
Postcode: Email address:
Telephone number:
(To save on postage and printing costs please supply your email address for all updates on rose events)
STEP 2: How I’d like to support the Hospice: I’d like to purchase and dedicate
Roses (minimum donation of £25 per rose)
Total donation I’m sending to the Hospice £
STEP 3: Payment options I enclose a cheque made payable to Greenwich & Bexley Community Hospice Please debit my Maestro* / Delta* / Visa* / MasterCard* (*delete as appropriate) Card number (Maestro only)
Expires
STEP 4: Gift Aid
STEP 5: Keeping in touch
I confirm that I am a UK Income or Capital Gains taxpayer. I have read this statement and want to Gift Aid this donation and any donations I make in the future or have made in the past 4 years to Greenwich & Bexley Community Hospice. I 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. I understand the charity will reclaim 25p of tax on every £1 that I have given.
We would like to send you information about our fundraising and events, and other ways in which you can help us. We will write to you by post unless you ask us not to. Please tell us if there are other ways you’d like to hear from us.
Gift Aid my donations to the Hospice in the last 4 years and all future donations until further notice. I am not a UK tax payer, please do not Gift Aid my donations. You may cancel this declaration at any time, and you must notify us if your tax paying status changes. Signature:
Yes, I am happy to receive occasional phone calls Yes, I am happy to receive text messages Yes, I am happy to receive emails No, please don’t send me information by post
Date:
Please send this form along with your donation in the freepost envelope provided, or return to: Freepost RTJU-GSSJ-KEAS, Greenwich & Bexley Community Hospice, 185 Bostall Hill, London, SE2 0GB. For more information about our Roses to Remember please contact Jackie Smith on 020 8320 5785 or jackiesmith@gbch.org.uk
Registered Charity No. 1017406
