Please print off this form, complete the details of yourself and your bank, and return it duly signed to: BSA, 15 Old Ford Road, London E2 9PJ. (Please do not try to email it.)
Standing Order Form
Please pay to CafBank Ltd (40-52-40), Kings Hill, West Malling, Kent, ME19 4TA, for the credit of the British Stammering Association (Account No. 00008336) the sum of
£3.90 (becomes £5 a month with Gift Aid*)
£7.80 (becomes £10 a month with Gift Aid*)
other: £.........................................................[figures then words]
(any amount, no matter how small, will help us to carry out our work)
on the ..... day of ..................20...... [please insert the first day of payment] and the like sum on the same day of every month, until this order is cancelled in writing, charging such payments to my/our
Account No: ........................................ Sortcode:...............................
Name and address of your bank:..............................................................
........................................................................................................
........................................................................................................
Signature:...............................................Date...........................
Title
First Name(s)
Surname
Address:
Postcode:
*Gift Aid
If you are a taxpayer, your donation can be increased by more than 28% - your £3.90 or £7.80 would become £5 or £10 respectively to BSA at no cost to yourself. All you need to do is tick the Gift Aid declaration below.
I want the British Stammering Association to reclaim tax on all donations I make from the date of this declaration and all donations I have made in the six years prior to this date (but no earlier than 6/4/2000).
You must pay an amount of income tax and/or capital gains tax equal to the tax we reclaim on your donations (including any BSA membership subscriptions).
The British Stammering Association is a company limited by guarantee registered in England No. 4297778.
Registered Office: 15 Old Ford Road, London E2 9PJ.
Registered Charity Nos: 1089967/SC038866 First registered 1978.