Village Hall Plaques

Village Hall Plaques

Date

Form Sender

Form Sender Email

example@example.com

Thank you for supporting our work to renovate Worth Hall by purchasing one of our brass plaques.

We suggest a minimum payment of £200, but you are of course free to contribute more if you wish.

Please complete the form below. You can opt to set up a single Direct Debit transfer with your bank here, or pay by card, whichever suits you.

These details will not be shown on the plaque!

Your Name*

First NameLast Name

Email*

you@example.com

Phone Number

We will not call you unless absolutely necessary

Your Text for the Plaque - 5 lines / 80 characters max.*

Note: your name will not be shown unless you enter it within this box. 0/80

Are you able to 'Gift Aid' your donation?*

YesNo, I'm not eligible

Thank you. We need just a bit more information to process your Gift Aid declaration:

Title

Mr / Mrs / Dr etc

House Name or Number

Postcode

I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand Worth Hall will reclaim 25p of tax on every £1 that I give.

As I have selected 'yes' above, I declare my wish to Gift Aid my donation today and any donations I make in the future or have made in the past 4 years to Worth Matravers Village Hall.