Gift Information

Donation Amount*
  • £25
  • £50
  • Other £

Contact Information

State / Province*
Confirm Email*

Data Protection

By providing us with any personal data, you consent to the collection and use of any information you provide in accordance with the above purposes and our privacy policy.  


We would like to keep you informed about the work of Breast Cancer UK, but will only contact you with your permission.  Therefore, if you would like to receive further information about our activities then please tick 'yes' below. We will not share your details with any other third party or organisation for marketing purposes other than that of Breast Cancer UK.  Our full privacy policy can be found online here 

Please note, when entering your payment card details, do not leave any spaces between the numbers.  Doing so will result in your card not processing. Thank you

Stay in Touch with Breast Cancer UK?*
  • Yes please, I would like to receive updates from Breast Cancer UK
  • No thanks, please do not add my details to your database

Payment Information

Yes, reclaim Gift Aid on all my donations so that each £1 is worth an extra 25p to Breast Cancer UK. This declaration is valid for the current tax year (6 April to 5 April), the previous four tax years and all future years. I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for the year of a donation that is at least equal to the amount of tax that all the charities and Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for the current tax year. I understand that other taxes such as VAT and Council Tax do not qualify.
Name on Card*
Card Number*
Additional Comments

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