I wish to become a Friend of The Champernowne Trust

Please complete the form. The Champernowne Trust will not pass on your details to any third party.

Select from the three options, as this allows us to plan our work in the future.

If you are a UK taxpayer, please also complete the Gift Aid declaration, as this will allow us to increase the value of your donation by 25%.

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

First Name *

Last Name *

Address 1 *

Address 2

City

Post Code *

Phone *

Email *

I have instructed by bank to create a Standing Order as follows payable to The Champernowne Trust bank account. My full name is the reference on each payment.

Monthly
Yearly

I have instructed my bank to make a one-off donation, payable to The Champernowne Trust bank account.

I am sending a cheque payable to The Champernowne Trust.

Gift Aid declaration

I am a UK taxpayer intending tax to be reclaimed on the donation detailed above, made under the Gift Aid scheme.

I want The Champernowne Trust (charity number 258813) to treat all donations that I make, from the date of they declaration until I notify you otherwise, as Gift Aid donations.

You must pay an amount of Income Tax and/or Capital Gains Tax at least equal to the tax that the charity reclaims on your donations in the appropriate tax year (currently 25p for each £1 you give).

Full Name

Date

2+3= *

The Champernowne Trust
20 Chamberlain Street
Wells
Somerset BA5 2PF

Bank account number: 00125825
Sort code: 30-97-41

Bank Address:
Lloyds Bank
38 Blue Boar Row
Salisbury
Wiltshire SP1 1DB