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Friends of Willberry Donation Scheme

* indicates required

Title

First Name *

Last Name *

Company

Phone Number *

Email Address *

Address *

Address Line 2

City

State/Province/Region

Postal / Zip Code

Country

How did you hear about us? *

Member Title (if different from above)

Member First Name (if different from above)

Member Last Name (if different from above)

Member Phone Number (if different from above) *

Member Email Address (if different from above)

Member Address (if different from above) *

Address Line 2

City

State/Province/Region

Postal / Zip Code

Country

Payment Plan *

Alternative Payment Plan

Gift Aid

Yes, Add Gift Aid - I confirm that I am UK taxpayer and I understand that if I pay less income tax and/or capital gains tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay the difference.
No, do not add Gift Aid.

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