Lastingham Organ Project   Donation Form & Gift Aid Declaration

  To:   The Honorary Treasurer, Nigel Roberts, Lastingham Parochial Church Council

           Ovins Well House  ·  Lastingham  ·  York  ·  YO62 6TJ

  Your details

Title .........  First name(s) ......................................Surname ..................................................... 

Address ..........................................................................................................................................

.............................................................................................. Postcode .......................

Telephone ............................. Email ...........................................................................

  I would like to support the Lastingham Organ Project by

□     a one-off donation of £ ..............

□     a regular donation of £ ............... per month for one year,

         starting on ............... 200....   Please complete the mandate.

□     participating in our Sponsor a Pipe scheme

Please enter the number of  pipes to be sponsored:

   ....... larger pipes @ £50 per pipe           £ ...............

   ....... medium pipes @ £30 per pipe      £ ...............

   ....... smaller pipes @ £10 per pipe        £ ...............

  Total     £  ..............

□     Please place me on your Concert Mailing List.

□     Please send me a specification of the new organ.

I enclose a cheque for £ ...................

Please make cheques payable to:  Lastingham PCC (Organ Project)

Gift Aid Declaration

If you are a taxpayer, we can reclaim tax on your gift, increasing its value by 25% at no cost to you.

I am a UK taxpayer and wish St Mary’s Church, Lastingham, to reclaim tax on any donations I may make to them after the date of this Declaration.

         Signature ...................................................................................... Date ..............................