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iMRI Scanner Appeal Donation Form
Donation Information
Amount:
£ 5.00
£ 10.00
£ 20.00
£ 50.00
£ 100.00
Other
£
*
Additional Information
Frequency:
Weekly
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Quarterly
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On:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Starting:
Ending:
Ending:
Corporate:
This donation is on behalf of a company
Comments:
Gift Aid:
I am a UK taxpayer and would like Manchester University NHS Foundation Trust (MFT) Charity to treat all donations I have made in the last four years and all donations I make in future as Gift Aid donations. I have paid income tax and/or capital gains tax for each tax year at least equal to the tax you, and all other charities and Community Amateur Sports Clubs (CASCs) that I donate to, reclaim on my donations for that tax year. I understand that VAT and Council Tax do not qualify.
What is Gift Aid?
How did you hear about the iMRI Scanner Appeal:
Bank Transfer/Payment
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Thankyou Newsletter
Trust Site/Hospital
TV Programme
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Xmas Stall
Contactless CBox
Acknowledgment by post:
I accept I will receive my receipt by email
I prefer to receive a receipt by post
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Phone:
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Payment Information
Cardholder's Name:
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Credit Card Number:
*
Card Type:
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*
Valid From:
01
02
03
04
05
06
07
08
09
10
11
12
/
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
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2013
2014
2015
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2017
2018
2019
2020
2021
(Maestro/Switch/Solo only)
Card Expiry:
01
02
03
04
05
06
07
08
09
10
11
12
/
2021
2022
2023
2024
2025
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*
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(Maestro/Switch/Solo only)
Card Security Code:
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Note: The Card Security Code is not required for Maestro, Switch and Solo cards.