Gift Information

Donation Amount*
  • £3
  • £5
  • £10
  • £25
  • £50
  • Other £

Would you like your donation to be restricted to a specific service within Sussex Partnership?

If so please let us know which one:

Contact Information

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

Staying in touch

Please let us know if you are happy to be contacted about Heads On, including news, information about future fundraising events and the projects that we support:

Payment Information

Yes, reclaim Gift Aid on all my donations so that each £1 is worth an extra 25p to Heads On. 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.
Amount*
£
Name on Card*
Card Number*
Additional Comments

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