Download the shop catalogue - Marie Curie Cancer Care

✃
Order form
your details: Please quote:
Please complete all sections in BLOCK CAPITALS
£10 funds half an hour of nursing
care by a Marie Curie nurse
Delivery address in BlOCK CAPitAls, if different
Mr/Mrs/Miss/Ms/Other:
Address:
Mobile (for delivery updates):
Daytime telephone:
Postcode:
We would like to email you as a cost effective way of keeping in touch.
We will use your email address to contact you about order queries. If
you are happy to be contacted by email in the future about our work
and fundraising activities, please tick here. n
Code Description size Quantity Price total
Mvs718 Mindbending conundrums & puzzles £5.99
Full terms and conditions also available on www.mariecurie.org.uk/shop
If you need more space, please write additional items on a separate sheet
of paper and attach to this order form.
two easy payment methods
Cheque – made payable to Marie Curie trading ltd.
Credit / Debit card – Please charge my card (tick accordingly)
visa n Mastercard n switch n Maestro n
Card no:
issue no. (Switch only)
Cvv number (last 3 digits on back of card)
Start date:____ /____ Expiry date:____ /____
Signature __________________________ Date _______________
Data protection statements:
We would like to keep you up to date on our work, shopping and fundraising
activities. Please tick here if you do not want us to contact you occasionally in
the future by post or phone. n
From time to time we would like to share your details with other organisations with
similar values for fundraising purposes. Tick here if you do not want us to share your
address/phone number. n
Email:
total goods cost
Postage and packaging
(Free with orders over £35*)
*excludes donations and p&p
express delivery extra £5
Donation
(please tick this box n if an
acknowledgement is required)
total order value
£
£4.95
Make a Gift Aid declaration
to make your gift go further
Thanks to the Government’s Gift Aid scheme, Marie Curie Cancer
Care can reclaim 25p on every £1 donation, increasing its value
by a quarter at no extra cost to you. Please tick one box.
n I am a UK taxpayer and would like to treat all donations I
have made for the four years prior to this year, and all donations
I make in future as Gift Aid donations.
n I am not a UK taxpayer
Today’s date D D M M y y y y
I confirm I have paid or will pay an amount of Income Tax and/or
Capital Gains Tax for each tax year (April 6 to April 5) that is at
least equal to the amount of tax that Marie Curie Cancer Care
will reclaim on my gifts for that tax year. I understand that other
taxes such as VAT and Council Tax do not qualify. I understand
the charity will reclaim 28p of tax on every £1 that I gave up to
April 5, 2008 and will reclaim 25p of tax on every £1 that I give
on or after April 6, 2008. Please let us know if your circumstances
or address change so that we can update our records. Thank you.
Charity Registration No. 207994 (England & Wales), SC038731 (Scotland)
£
£
£