Single Donation

Donation Amount*
  • £10
  • £25
  • £100
  • Other £

Your Details

Country*
State / Province*
Address*
City*
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Email*
Confirm Email*
Phone*

Thank you for Supporting Us

Reason for donation...
  • In memory of a loved one
  • To celebrate a special event (birthday, wedding, anniversary)
  • I receive a LifeCare service(s)

Keeping in Touch

We would like to send you communications from time to time about the difference donations like yours are making to us.

 

Please indicate your opt in consent, by ticking the box(es) below.

Email*
  • Opt-in
  • Opt-out
Post*
  • Opt-in
  • Opt-out
Telephone*
  • Opt-in
  • Opt-out
SMS*
  • Opt-in
  • Opt-out
Consent Channel*
  • I give my consent to be contacted by the methods I have indicated above

Payment & Gift Aid Details

I am a UK tax payer and I would like to treat all donations I have made to LifeCare Edinburgh in the past four years, and any donation I make in the future as Gift Aid donations until I notify you otherwise. I confirm that I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of Gift Aid claimed by LifeCare Edinburgh or it is my responsibility to pay any difference. LifeCare Edinburgh will reclaim 25p of tax on every £1 that you have given. Please notify us if you: Wish to cancel this declaration. Change your name or home address. No longer pay sufficient tax on your income and/or capital gains.
Amount*
£
Name on Card*
Card Number*
Additional Comments

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