Gift Information

Donation Amount*
  • £5
  • £10
  • £25
  • £50
  • £100
  • Other £

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*
My donation is on behalf of an organisation
I would like to receive news and updates from Wells for India*
  • WaterWise magazine by post
  • WaterWise magazine by e-mail
  • All news and updates
  • No thank you
What prompted me to donate

Payment Information

Yes, reclaim Gift Aid on all my donations so that each £1 is worth an extra 25p to Wells for India. This declaration is valid for the current tax year, the previous four 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 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

Security Code