Academy Fund Donation

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Email *

Title *

Mrs

Miss

Other:

First Name or Initials *

Surname *

Full Home Address: *

Post Code *

Email address *

Name of child/children at our school? *

Please tick one of the following boxes: *

I/We would like to make a regular donation by Standing Order

I/We would like to make a single payment via ParentPay

I am unable to make a donation at the moment

Amount:

If you are planning to set up a standing order, our bank details are:

A/C number: 21533668
Sort Code: 30-13-30
Account name: Chalfont St Peter CofE Academy - Ac No2

Please tick one of the following boxes: *

I want to Gift Aid my donation and any donations I make in the future or have made in the past 4 years to Chalfont St Peter Church of England Academy. I am a UK tax payer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year, it is my responsibility to pay any difference.

I am unable to Gift Aid my donation at the moment

Please notify us if you wish to cancel this declaration, change your name or home address or no longer pay sufficient tax on your income and/or capital gains. If you pay income tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue to adjust your tax code.

Signed (please type in your full name) *

Date *

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A copy of your responses will be emailed to the address you provided.

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