This is a multi-purpose Donation Form designed to be printed out, completed by hand, and ...
1. mailed to us along with your donation
2. mailed to us in order to set up a standing order
N.B. Please mail the completed form to:-
Thank you for agreeing to help us by donations to promote our work!
Please complete the appropriate sections below, and if sending a cheques/postal orders/ CAF voucher, please make payable to "Gwalior Children's Hospital".
* I have pleasure in enclosing a gift of £250 / £120 / £..................or..................
(any convertible currency) to help Children in India.
* Please debit my Switch/ Master/ Visa/ Amex/ Diners Club/CAF card number
Regular Donation (Standing Order)
Please pay Gwalior Children's Hospital
£ .......... or................(any convertible currency)
monthly / quarterly / annually (delete as appropriate)
Starting on .... /.... / 20 .... until further notice.
** Gift Aid (UK Donors only)
Please treat all my donations from this date and hereafter as gift aid donations. I want the charity to reclaim tax on my donations
* Please use my donation(s) as per the charity needs.
* Please delete as appropriate. Please fill in the amount, etc., as you wish.
Would you like a receipt? YES / NO
** For donors in U.K. only -- Remember to notify us if you no longer pay an amount of income tax or capital gain tax equal to the tax we reclaim on your donations (28p for every pound you give).If you are a higher rate tax payer, do not forget to claim relief of 18% ( i.e.23p for every pound you give ) in your self assessment return from Inland Revenue.
All donations in U.S.A. with tax benefits are accepted through American fund for charities, a 501 C non profit organisation. Make your cheques in the name of "American Fund for Charities for Gwalior Childrens Hospital" or Contact us for further information.
All Donations in India are exempted for tax under 80G income tax rules. Make your cheques payable to "Gwalior hospital and Education charitable trust" and send it to us.
Donations in any convertible currency can be made.
N.B. Please print and mail the completed form with your donation to:-
If sending a cheques/postal orders/ CAF voucher, please make payable to Gwalior Children's Hospital