Your Donation

We rely on donations to enable us to continue providing hope to people affected by sight loss.


     £20 could enable us to buy baking
     materials for our group for blind and
     partially sighted children, enabling them
     to gain confidence and learn new skills


     £10 could enable one of our hospital
     volunteers to spend an hour with
     someone who has just been told they are
     losing their sight, offering emotional
     support and practical advice


     £5 could pay the fuel costs to enable our
     mobile resource van to attend a local
     event providing information, advice and
     access to equipment to people affected by
     sight loss


Whatever the size of your gift, it will make a real difference to someone's life. Thank you so much.



Please select the amount you wish to donate

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

If you have selected 'other' please enter the amount you wish to donate in the white box before completing the rest of this form.

Contact Information

Confirm Email*

Keeping in touch

We would love to keep you up to date with information about the difference your donation is making and about our fundraising events/activities. Our newsletter features information about upcoming events from sponsored tandem cycling events to choir concerts, as well as stories of how the money raised is making a real difference to people's lives.

Please let us know how you would like us to contact you

By email*
  • Yes please
  • No thank you
By post*
  • Yes please
  • No thank you
By phone*
  • Yes please
  • No thank you

Your details will be kept securely and will not be shared with anyone else. Donation records will be kept securely for 7 years for auditing purposes. You may change your contact preferences or ask for your details to be removed from our mailing list at any time by calling 01332 292262 or emailing


When entering your card number below  please do not leave any spaces. Thank you.

Payment and Gift Aid

Yes, reclaim Gift Aid on all my donations so that each £1 is worth an extra 25p to Sight Support Derbyshire. I confirm 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 tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that if I pay less income tax in the current tax year than the amount of Gift Aid claimed on all of my donations it is my responsibility to pay any difference. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1 that I give or have given in the last four tax years.
Name on Card*
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