Gift Aid Declaration

Please print this page, complete and return to the following address:

The Anita Goulden Trust,
144 Bronsart Road,
London, SW6 6AB, UK.

Donors Name:

Title:

Forenames:

Last Name:

Address:



Postcode:

I would like all the donations I/we* make to The Anita Goulden Trust after 6th April 2000 to be treated as Gift Aid donations. Please reclaim tax on my/our* donation.

*Delete as applicable.

Sign:

Date: