regular donation

Direct Debit Form

I am pleased to confirm the following details to set up a direct debit to Nightingale Hammerson.

My Details

Title(Required)

Name(Required)

First Name Surname

Address(Required)

Address Line 1 Address Line 2 City Postcode

Phone(Required)

Gift Details

I would like to give the following amount per month(Required)

Please enter the start date in which you would like your payment to be debited on the first of the month.(Required)

Make your gift go further

Gift Aid your donation and we will receive and extra 25p for every pound you donate, at no extra cost to you. To qualify for Gift Aid you must be a UK tax payer and pay at least as much Income and/ or Capital Gains Tax as the amount to be reclaimed on all your charitable donations in the appropriate tax year.(Required)

Yes, I would like Nightingale Hammerson to treat all donations that I have made in the past 4 years and all future donations from the date of this declaration as Gift Aid donations.

Please inform us if you no longer pay UK tax at any time after the date of this declaration.