Help stop the suffering of children caused by disease and disability
Sponsorship form
Did you know - If you are a UK tax payer we
Challenge events
can claim tax back on your donation.
We who have given our names and addresses below, and who have ticked the box entitled Gift Aid want Action Medical Research to reclaim tax on the donation detailed below, given on the date shown. We understand that each of us must pay income tax or capital gains tax equal to the tax reclaimed by the charity on the donation.
Participant’s name Event
Date
SPINATHON - ACTION MEDICAL RESEARCH
07/05/2011
Address Postcode Full name
House number
Postcode
Amount Amount Date given pledged given (dd/mm/yy)
Sub total £ If you run out of room for names don’t worry, photocopies of this side of the form will be accepted
Please help us to fund the next medical breakthrough for children Action Medical Research registered office: Vincent House, Horsham, West Sussex RH12 2DP T 01403 210406 F 01403 210541 E info@action.org.uk www.action.org.uk
Paying in slip No.
Gift Aid 3