Your Name Your Address Your Contact Details Payment details Amount*£ Card Number* Credit Card* VisaMasterCardAmerican ExpressDiners ClubDiscoverJCB Expiry Date* Security Code/CVC* Gift Aid I would like to make this gift* A One Off An Ongoing Commitment to Help I would like to donate* MonthlyQuarterlyAnnually Please tell us why you are making a donaton, e.g for an event or in honour of someone with Rett Syndrome Gift Aid Yes I would like you to claim Gift Aid on my donation I want all donations I’ve made to you in the past four years and all donations in future to be treated as Gift Aid donations until I notify you otherwise. 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. We will claim 25p on every £1 you donate. I would like to be kept up to date with your projects and activities by the methods I choose below Email Post Sms Phone There is a problem with your payment – Please wait …