Standing order form

Name of your bank*

Branch address*

Town/City*

Postcode*

Date

£3£10£25

Other

Each*

WeekMonthYear

Until further notice and debit my account accordingly.

Name of account to be debited*

Sort code*

Account number*

Signature*

Date

Title

Name*

First NameLast Name

Home address*

Town/city*

Postcode*

Email address*

example@example.com

How do you want to be contacted?

Email and PostEmailPost

giftaid it

I want to Gift Aid my donation and any donations I make in the future or have made in the past four years. Iam 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 responsiblity to pay any difference.

Tick to boost your donation by 25p of Gift Aid for every £1 you donate.

'Carmarthen Foodbank is committed to protecting your privacy and will process your personal data in accordance with current Data Protection legislation. Carmarthen Foodbank collects information to keep in touch with you and supply you with information relating to our work. To unsubscribe from our newsletter, send a message to the email address above with the word unsubscribe in the subject line. A full data privacy statement for financial donors is available from the foodbank on request.

This form will be printed and sent to your named bank or building society.