One-off Donation

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Please accept my donation of £____________


Mr/Mrs/Miss/Ms___________ Initials_________

Surname________________________________________________________

Address________________________________________________________

_______________________________________________________________

_______________________________________________________________

Postcode_______________________________________________________

Telephone No.__________________________________________________

Email Address__________________________________________________

Please tick this box if you do not wish to receive further communications from North West Cancer Research Fund.

I wish to make a regular donation. Please send me a banker's order form.

I enclose my cheque/postal order made payable to North West Cancer Research Fund.

OR please debit my Mastercard

Visa

Access

CAF CharityCard

>Account number________________________________________________

Expiry date

Today's date___________________________________________________

Signature______________________________________________________

I am a UK taxpayer and I want North West Cancer Research Fund to treat all donations I make from 6 April 2000, until I notify you otherwise, as Gift Aid donations. I am currently paying income tax or capital gains tax that is equal to or more than the tax deducted from my donation.

Please complete and return this form, with your donation if appropriate, to the General Secretary, North West Cancer Research Fund, FREEPOST LV 717, Liverpool L7 1BR.