To the Manager (name of bank) ………………………………………………………………………….
Bank/Building Society* Account No: …………………………………… Sort Code: ____/____/____
Branch address: ………………………….………………………………………………………………………….
Please pay £ _________________ to the Centre for Complementary Care, Eskdale each week/month/ quarter/year * starting on ____/_______/20___ until further notice.

Signature:……………………………..……………………………………………………………………....………
Date: …………………………………….20____
Full name: (Rev/Dr/Mr/Mrs/Ms/Miss):………………..……………………………………………………
Address: ……………………………………………………………………………………………..………………….
………………………………………………………………………………………………………………… ..…………..
Postcode: …………………………….….. Tel No (with STD code): …………..………..……………

*Delete as appropriate.

Bank use only: National Westminster Bank plc, Egremont Branch. Sort Code: 60-07-34. 29 Market Place, Egremont, Cumbria, CA22 2AQ. For the account of Knott End Centre for Complementary Care, A/c No: 03909921.

If you are a tax payer and have NOT already completed a Gift Aid declaration, please would you do so – it enables us to claim back the tax on your donation – however much you choose to give.

GIFT AID DECLARATION

Please reclaim the tax on all my donations to The Centre for Complementary Care, Eskdale, made since 6th April 2000, and any I make from now on.

• Please remember to tell us if you no longer pay an amount of UK income or capital gains tax at least equal to the tax we reclaim on your donations (currently 28p for every £1 you give).
• Higher rate tax payers can claim further tax relief in their Self Assessment tax return.
• Please remember to tell us if you change your name and address.

Signed: ………………..………….………………………….……………………………..…………..…….

Dated: ……………………………….…………..…200_____

Please complete the section below in full – I’m afraid “as above” won’t do
– the two parts of the form go separate ways!

Title: (Rev/Dr/Mr/Mrs/Ms/Miss):…………….. Forename(s): …………………………………………….

Last name: ……………………………..……………………..……………………………….…………………….......

Address:………………….………………………………….…………………………………………………………........

…………………………………………………………..…………………………………………..…………………...........

Telephone number: ……………………………………..…………………………………………..…………….......

Please return the whole form to: Moira Briggs, Manager, Centre for Complementary Care,
Muncaster Chase, Muncaster, Ravenglass, Cumbria, CA18 1RD.