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GIFT AID FORM 

 

Please complete the form below and return it to Haven House Treasurer, Dr Jackie Long, c/o Haven House 

DETAILS OF DONOR 

 

TITLE…….FORENAME(S)…………………………………………….………… 

 

SURNAME………………………………………………………………………….. 

 

ADDRESS……………………….…………………………………………………… 

 

…………………………………………………………………………………….….. 

 

……………………………………………………………POSTCODE…………… 

 

TELEPHONE No…………………………………………………………………… 

 

EMAIL……………………………………………………………………………… 

 

DECLARATION 

 

I WISH THE CHARITY ‘Haven House’ TO TREAT ALL DONATION(S) THAT I MAKE TO THIS CHARITY UNTIL I NOTIFY YOU OTHERWISE AS GIFT AID DONATIONS.