Please print this page and complete the following:-

I enclose a crossed cheque in the sum of £________ made payable to

MWB - The Maria Watt Birmingham Foundation for Childhood & Teenage Leukaemia.


Name

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Address

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Telephone Number (may be omitted)

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Gift Aid

Your kind donation could be worth substantially more to us, as we qualify for Gift Aid rebates.  If you are a UK taxpayer, we receive £12.82 for every £10.00 you give.  If you pay tax at 40%, we will still receive £12.82, but you can also claim tax relief, reducing the cost to you to just £7.69.

Simply read and confirm the statement below to enable us to claim Gift Aid on your kind donation:

I am a UK tax payer. I authorise MWB – The Maria Watt Birmingham Foundation for Childhood & Teenage Leukaemia to reclaim from the Inland Revenue the Gift Aid allowance for my personal (or sole-trader or partnership) donations from 6th April 2007

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SIGNED

Please forward completed form and cheque to:-

The Trustees,

MWB – The Maria Watt Birmiingham Foundation for Childhood & Teenage Leukaemia,

14, Radlow Crescent,

Marston Green,

Birmingham.

B37 7LZ.

THANK YOU YOUR CONTRIBUTION IS INVALUABLE TO US