Donation Amount*
  • £5
  • £10
  • £20
  • £50
  • Other £

Contact Information

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

When you submit one of our online forms, you agree to us recording your details on our database.  This is so we can contact you in the event of any problems with processing your donation, or if we have any follow-up questions.

We will also contact you from time to time to keep you up to date with what is happening at the charity. Your details will be kept securely and never shared with any third parties.

 

If you would prefer us not to use your details in this way, you can email cara@revivemssupport.org.uk, telephone 0141 945 3344, or write to us at Revive MS Support, Moorpark Court, 29 Dava Street, Glasgow G51 2JA.

Payment Information

Yes, reclaim Gift Aid on all my donations so that each £1 is worth an extra 25p to Revive MS Support. 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 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.
Amount*
£
Name on Card*
Card Number*
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