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DONATIONS

Donation Form

Membership/Donation Form for M.A C. H.

To Nick Linney, the Secretary, MDG,
Flat 3, 5 Victoria Road
Twickenham, TW1 3HW,

Name: …………………………………………………………………
Address: …………………………………………………………………
…………………………………………………………………
…………………………………………………………………
Email: …………………………………………………………………
Tel: …………………………………………………………………


I/We wish to apply for Individual/Household/Group membership as indicated below:

Individual: £10:00 per year ……
Joint household/family: £15:00 per year ……
Group (Offices, Clubs etc.): £15:00 per year ……


I/We wish to make a donation of: £……………………


Gift Aid declaration
(Please sign this declaration whether you are applying for membership or making a donation, as this will allow us to receive extra money by claiming back the tax you have already paid on the amount you are giving.)

I am / We are a tax payer in the United Kingdom relative to amounts donated and would like the charity to treat all donations I make from the date of this declaration until I notify you otherwise as Gift Aid donations. I am over 18



Signed: ………………………………………….

Date: ……………………………….…………


Mali Development Group - Charity Registration Number: 1088140