SOUND SEEKERS STANDING ORDER and/or DONATION FORM

This Form should be printed out, and filled in by hand.

NB: If you would like to make an individual donation please fill in the top part of the Form. If you would like to become a regular supporter of Sound Seekers, please complete the standing order part at the bottom. In all cases please complete the 'your details' section at the top. Where appropriate, please also remember to complete the Gift Aid Declaration. Thank you.

YOUR DETAILS (BLOCK CAPITALS PLEASE)

Your Title: (Mr/Mrs/Miss/Ms/other) _______________________
Your Name: __________________________________________
Your Address: ________________________________________
____________________________________________________
Postcode: ____________________________________________
Tel: _________________________________________________
email: _______________________________________________

INDIVIDUAL DONATION

I/wish to donate £100 £50 £25 other £ ________

I/we enclose a cheque/postal order/charity voucher made payable to
Sound Seekers

I/we wish donate using Access Visa CAF Charity Card World People Card

Please debit my account number

- - -

expiry date _ _ / _ _ Signature_________________________ Date__________

GIFT AID DECLARATION
(Open only to UK Tax payers)

I wish that the Sound Seekers treat

the enclosed donation of £
the donation(s) of £ _____ which I made on _ _ / _ _ / _ _ _ _
all donations I make from the date of this declaration, until I notify you otherwise
all donations I have made since 6th April 2000, and all donations I make from the date of this declaration, until I notify you otherwise

as Gift Aid donations.

I confirm that I have paid UK Income Tax and/or Capital Gains Tax at least equal to the tax that Sound Seekers will reclaim on this donation.

Signed: ______________________________________________

Date_______________________20____

STANDING ORDER FORM
If you would like to become a regular supporter of Sound Seekers, please complete this standing order form.

To:
Bank Name: __________________________________________
Full Bank Address: _____________________________________
____________________________________________________
Postcode: ____________________________________________

Please make the payments detailed below debiting my/our account until further notice.

Sort Code __ __ / __ __ / __ __ (YOUR BANK SORT CODE IS ON THE TOP RIGHT HAND CORNER OF YOUR CHEQUE)

A/C No. __ __ __ __ __ __ __ __ (YOUR BANK ACCOUNT NO. IS THE THIRD FROM THE LEFT OF THE 3 BOTTOM NUMBERS)

A/C Name __ __ __ __ __ __ __ __ _ __ __ __ __ __ __ __

Please pay SOUND SEEKERS: Lloyds TSB, (Sort-Code 30-98-97), (Account number 1472344)

£ .......... monthly / quarterly / annually (delete as appropriate)

Starting on .... /.... / 20 ....

Signed: _____________________________________________

Date_______________________20____

To: The Bank (please quote this donor code on all correspondence and payment.)

Donor Code ___________________________________

(PLEASE DO NOT SEND THIS FORM DIRECT TO YOUR BANK!)
When completed, please return to:

Sound Seekers
(The Commonwealth Society for the Deaf)
34 Buckingham Palace Road
London
SW1W 0RE