To pledge a one-off or regular gift, or both, to the Impact project over a period of up to 3 years, please complete the form below and Gift Aid if you can:

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

I/We wish to financially support the repairs and reordering of St Michael le Belfrey Church with (complete one or more options below as appropriate):

A one-off gift

monthly gifts

annual gifts

Please give details of your pledge(s) in the box below

E.G. A one-off gift of £_______ on ___ (date) and/or Monthly gifts of £_______ over ___ years (1-3 years as preferable*) from ___ (date) and/or Annual gifts of £_______ over ___ years (1-3 years as preferable*) from ___ (date)

Gift Aid. (I am a UK taxpayer 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 would like to Gift Aid my donation

By completing your details above you permit us to contact you with relevant information and updates about the Impact Project.

If you do not wish to be contacted please tick here

Pledges should be paid using the Impact bank account which is DIFFERENT to the account used for your regular giving. Please note the payee name will appear the same.

Payee: St Michael le Belfrey PCC

Sort Code: 16-34-80

Account No: 11289130

If you have any questions or would like to discuss a different payment plan, please get in touch with Melissa (impactgiving@belfrey.org).

All pledges and donations are strictly confidential between you and the Finance Manager and we understand that your circumstances may change so this form is merely a commitment, not a contract.

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