Gift Aid Declaration

Sustainable Merton  Registered Charity No.1123041

The Treasurer
18 Haydon Park Road
London SW19 8JY

Details of donor

Title ...... Forename(s) ..................................... Surname ...................................

Address ............................................................................................................

..........................................................................................................................

................................................................. Post Code..................

e-mail............................................................................(if you would like to receive newsletters. SM will not pass on your e-mail address to anyone else)

*I enclose £10 for membership

*I enclose £......... as a donation

*I enclose £......... as membership and as an additional donation

I want the charity to treat all donations I make from the date of this declaration until I notify you otherwise as Gift Aid donations.

*delete as appropriate

Date ......../......./..........