14. 15. 16. 17. MIDLANDS AIR AMBULANCE CHARITY. Gloucestershire ⢠Herefordshire ⢠Shropshire ⢠Staffordshire. West
Official Sponsorship Form Name: Company/Organisation (if applicable): Address: Postcode: Daytime Tel:
Email:
Event or Challenge: * YOUR TICK CAN HELP MIDLANDS AIR AMBULANCE CHARITY RAISE EVEN MORE MONEY: If your sponsorship donation is from taxed income, please place a tick in the box provided. The Charity will then be able to reclaim tax on your donation from the Inland Revenue at no cost or inconvenience to you. In order for us to claim Gift Aid we require your full name, home address and postcode, NOT works address.
EG
SPONSOR NAME
HOME ADDRESS
TOWN
POSTCODE
Ex Ample
123 Anytown Avenue, Local area
Anytown
AB1 1CD
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Sub Total
MIDLANDS AIR AMBULANCE CHARITY Gloucestershire • Herefordshire • Shropshire • Staffordshire West Midlands • Worcestershire
20
Saving Lives by Saving Time
Call 0800 8 40 20 40
years
or visit www.midlandsairambulance.com 1991
Hawthorn House, Dudley Road, Stourbridge, West Midlands DY9 8BQ
TO
201
1
£
RECLAIM GIFT AID*
£25
✓
SPONSOR NAME
HOME ADDRESS
TOWN
POSTCODE
20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 Grand Total
MIDLANDS AIR AMBULANCE CHARITY Gloucestershire • Herefordshire • Shropshire • Staffordshire West Midlands • Worcestershire
Please make cheques payable to: MIDLANDS AIR AMBULANCE CHARITY. Please do not send cash. Thank you.
20 years
Midlands Air Ambulance, Charity, Hawthorn House, Dudley Road, Stourbridge, West Midlands DY9 8BQ 201 1 1991 Tel: 0800 8 40 20 40 Email:
[email protected] Web: wwww.midlandsairambulance.com TO
£
RECLAIM GIFT AID*
