Please complete the declaration form and then
click on submit >> to email the form to us directly.

Click on clear >> if you have entered your details incorrectly and wish to start again.

Click on close >> to close this window.

Click on print >> before submitting or closing the form to print a hardcopy.

Alternatively, you can download a copy of the form to complete later.

Right click the download link and select "Save Target As..." and save to a local directory. The file is in Microsoft Word and is compressed using Winzip.

If you have completed a hardcopy declaration please hand it to the Rector, one of the Churchwardens, or the Treasurer.

I would like to donate to St. Andrew's using Gift Aid.

Note: all fields except donate by Standing Order are Mandatory.

Name:
Address:
Postcode:
Tel:
E-mail:

	I would like Medstead PCC to reclaim tax on all my donations made from 6 April 2007 until further notice.
	I would like to donate regularly by Standing Order.
	I understand I must pay sufficient income or capital gains tax to at least equal the tax the Church may reclaim on my donations. In 2007 this is 28p for every £1 I give. From April 2008 this will reduce to 25p.
Signed:
Dated:

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