How you can help

We are very grateful to all the help and financial support we receive from the local community and we could not have celebrated our 15th anniversary without your marvellous support.

However, the demand for our services continues to rise along with the cost of nursing care. We are therefore appealing to you to help us support our future.

One of the easiest ways to do this is to give money to the Prince of Wales Hospice on a monthly basis. Alternatively a one-off donation would be warmly welcomed. Please print out and complete one of the forms on this page to support us.

HOSPICE DONATION FORM

I would like to support the Prince of Wales Hospice by making a donation of £_______

Name_______________________________________________________________

Address_____________________________________________________________ ____________________________________________Postcode________________

Telephone___________________________________________________________ [ ]

Please tick here if you are a taxpayer and would like us to reclaim tax* on all donations you have made from April 6 200 and any donations I make in the future, until notified otherwise. *Please let us know if you no longer pay an amount of income tax or capital gains tax equal to the tax we will reclaim on your donation, currently 28p for every £1 you give.

Signed____________________________________________Date______________

Please complete and return to Paul Johnson, Fundraising Manager, The Prince of Wales Hospice, Halfpenny Lane, Pontefract, West Yorkshire, WF8 4BG. Please remember to sign the gift aid declaration so we can increase the value of your donation.

[ ] Please tick here if you are a taxpayer and would like us to reclaim tax* on all donations you have made from April 6 2000 and any donations I make in the future, until notified otherwise. *Please let us know if you no longer pay an amount of income tax or capital gains tax equal to the tax we will reclaim on your donation, currently 28p for every £1 you give.

Signed_____________________________________________________Date____________________

STANDING ORDER REGULAR PAYMENT INSTRUCTION

Name______________________________________________________________________________

Address__________________________________________________________________________________ ________________________________________________Postcode_____________________

Telephone__________________________________________________________________________

Please pay the Prince of Wales Hospice until further notice: £__________________________________ Per month/quarter/year (please circle) starting on___________________________________________ (Please allow one month from today) Name of bank/building society _________________________________________________________

Branch address________________________________ ______________________________________________________Postcode_____________________

Account holder name__________________________________________________________________

Account number_____________________________________________________________________

Branch sort code_____________________________________________________________________

Signature___________________________________________________Date____________________

FOR BANK USE ONLY

Please pay to: Yorkshire Bank PLC, Ropergate, Pontefract, West Yorkshire, WF8 1LQ The Prince of Wales Hospice Account Number 16160892 (sort code 05-06-71)

Under the terms of the Data Protection Act, The Prince of Wales Hospice will retain and use the data you have provided for administrative purposes and to inform you of its fundraising and other activities. We hope you will want to remain in touch with our work, but if you would prefer not to receive future mailings, please tick this box [ ] We will not pass your information to any other organisation. Thank you for your support. Registered charity number 514999

DO NOT RETURN THIS FORM TO YOUR BANK