Christmas Pledge Form

Christmas Pledge Form

Please use this short form to promise funds to our charity this Christmas
By filling out this pledge form, you are promising funds to our charity, no payment is needed today.

This promise is to support a match funding opportunity the Merlin Neuro Therapy Centre was successful for with Big Give, which we are hoping will raise £10,000 for our charity.

Your pledge must be paid between the 2nd of December - 9th of December during our Big Give Christmas Campaign Week. If you make payment outside of these dates, it may mean that we won't benefit from your donation being doubled.
Customer Details:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
How much are wishing to pledge to our charity this Christmas?*
Would you like to be kept up to date with Merlin news and events?*

YesNo
Will Gift Aid be claimable on this donation?

YesNoUnsure
What happens next?

Now that you have generouly pledged to our charity, we will send you a link that you will need to follow to pay for your pledge. We will aim to send this payment link to you ahead of the campaign week.

If you are unable to use this form or lin, please pop in and see one of us at thr Merlin Centre, or give us a call on 01726 885530.
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