Thank you for donating to CLIC Sargent. Your generous donation will enable us to help children and young people coping with cancer, and their families. Please fill in the form on the next few pages to make your donation. Thank you! You are donating £10.00 to support children and young people with cancer. Please complete all sections of your Gift Aid declaration to increase your donation by 25p of Gift Aid for every £1 you donate. Your home address is needed to identify you as a current UK taxpayer. Gift aid * Yes, I would like to Gift AidI want to Gift Aid my donation and any donations I make to CLIC Sargent in the future or have made in the past four years. I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference. I understand that Gift Aid is reclaimed from the tax that I pay for the current tax year. No, I am not a UK Taxpayer (please let us know if this changes) Please call us on 0845 120 4442 or email firstname.lastname@example.org if you Need to cancel this declaration Change your name or home address No longer pay sufficient tax on your income and/or capital gains Reason for donation * - Select -Fishponds arson attackReceived an email or letter from CLIC SargentWig WednesdayPractice-a-thonThe Big Buzz/I shaved my headSponsoring someoneSkydive/trek/cycleUK walk/swimRun or triathlonFacebook/Twitter AppealIn memory of someoneWallis PartnershipIn celebration of birthday/wedding/otherCollection/event by a schoolCollection/event/donation by a companyCollection/event by a groupPersonal donationOther Please add more details here, for example the name of your company or the person you are sponsoring.