YMCA Teesdale Online Donation Form

Full Name *

First Name Last Name

E-mail

Phone Number

Area Code Phone Number

Address *

Street Address

Street Address Line 2

Town County

Postal Code Country

Comments

Gift Aid Declaration

I confirm 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 YMCA North Tyneside will reclaim 25p of tax on every £1 that I have given.

Contact Preferences

Please tick this box if you are happy for us to keep you updated on how your contributions will be used to help better our local community.

Donation amount *

Three pounds £ 3.00 GBP

Five pounds £ 5.00 GBP

Ten pounds £ 10.00 GBP

Twenty pounds £ 20.00 GBP

Fourty pounds £ 40.00 GBP

Sixty pounds £ 60.00 GBP

One hundred pounds £ 100.00 GBP

Total £ 0.00 GBP

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

YMCA Teesdale Donation Form