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Miles for Home Fundraiser
Donation Amount
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Total Amount
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Email Address
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Gift Aid
By selecting 'Yes', I confirm that I am a UK Income or Capital Gains taxpayer. I have read this statement and want Integrate Youth for Christ to reclaim tax on this donation, I understand that if I pay less Income Tax / or Capital Gains tax in the current tax year than the amount of Gift Aid claimed on all of my donations it is my responsibility to pay any difference. I understand the charity will reclaim 25p of tax on every £1 that I have given. Remember: You must provide your full name, home address and postcode for us to be able to claim tax back on your donation.
Gift Aid
Yes
No
First Name
Last Name
Street Address
Address Line 2
Address Line 3
Town/City
County
- select State/Province -
Aberdeen City
Aberdeenshire
Angus
Antrim and Newtownabbey
Ards and North Down
Argyll and Bute
Armagh City, Banbridge and Craigavon
Baden-Württemberg
Bayern
Bedfordshire
Belfast
Berkshire
Berlin
Blaenau Gwent
Brandenburg
Bremen
Bridgend
Bristol, City of
Buckinghamshire
Caerphilly
Cambridgeshire
Cardiff
Carmarthenshire
Causeway Coast and Glens
Ceredigion
Cheshire
Clackmannanshire
Clwyd
Co Antrim
Co Armagh
Co Down
Co Fermanagh
Co Londonderry
Co Tyrone
Conwy
Cornwall
County Durham
Cumbria
Denbighshire
Derbyshire
Derry City and Strabane
Devon
Dorset
Dumfries and Galloway
Dundee City
Dyfed
East Ayrshire
East Dunbartonshire
East Lothian
East Renfrewshire
East Riding of Yorkshire
East Sussex
Edinburgh, City of
Essex
Falkirk
Fermanagh and Omagh
Fife
Flintshire
Glasgow City
Gloucestershire
Greater Manchester
Gwent
Gwynedd
Hamburg
Hampshire
Herefordshire
Hertfordshire
Hessen
Highland
Inverclyde
Isle of Anglesey
Isle of Wight
Kent
Lancashire
Leicestershire
Lincolnshire
Lisburn and Castlereagh
London
Mecklenburg-Vorpommern
Merseyside
Merthyr Tydfil
Mid Glamorgan
Mid Ulster
Mid and East Antrim
Midlothian
Monmouthshire
Moray
Na h-Eileanan Siar
Neath Port Talbot
Newport
Newry, Mourne and Down
Niedersachsen
Nordrhein-Westfalen
Norfolk
North Ayrshire
North Lanarkshire
North Yorkshire
Northamptonshire
Northumberland
Nottinghamshire
Oldham
Omagh
Orkney Islands
Oxfordshire
Pembrokeshire
Perth and Kinross
Powys
Renfrewshire
Rheinland-Pfalz
Rhondda, Cynon, Taff
Rutland
Saarland
Sachsen
Sachsen-Anhalt
Schleswig-Holstein
Scottish Borders
Shetland Islands
Shropshire
Somerset
South Ayrshire
South Glamorgan
South Gloucestershire
South Lanarkshire
South Yorkshire
Staffordshire
Stirling
Suffolk
Surrey
Swansea
Thüringen
Torfaen
Tyne and Wear
Vale of Glamorgan, The
Warwickshire
West Dunbartonshire
West Glamorgan
West Lothian
West Midlands
West Sussex
West Yorkshire
Wiltshire
Worcestershire
Wrexham
Post code
My billing address is the same as above
Billing Name and Address
Billing First Name
*
Billing Middle Name
Billing Last Name
*
Street Address
*
City
*
Country
*
- select -
United Kingdom
Germany
State/Province
- select State/Province -
Aberdeen City
Aberdeenshire
Angus
Antrim and Newtownabbey
Ards and North Down
Argyll and Bute
Armagh City, Banbridge and Craigavon
Bedfordshire
Belfast
Berkshire
Blaenau Gwent
Bridgend
Bristol, City of
Buckinghamshire
Caerphilly
Cambridgeshire
Cardiff
Carmarthenshire
Causeway Coast and Glens
Ceredigion
Cheshire
Clackmannanshire
Clwyd
Co Antrim
Co Armagh
Co Down
Co Fermanagh
Co Londonderry
Co Tyrone
Conwy
Cornwall
County Durham
Cumbria
Denbighshire
Derbyshire
Derry City and Strabane
Devon
Dorset
Dumfries and Galloway
Dundee City
Dyfed
East Ayrshire
East Dunbartonshire
East Lothian
East Renfrewshire
East Riding of Yorkshire
East Sussex
Edinburgh, City of
Essex
Falkirk
Fermanagh and Omagh
Fife
Flintshire
Glasgow City
Gloucestershire
Greater Manchester
Gwent
Gwynedd
Hampshire
Herefordshire
Hertfordshire
Highland
Inverclyde
Isle of Anglesey
Isle of Wight
Kent
Lancashire
Leicestershire
Lincolnshire
Lisburn and Castlereagh
London
Merseyside
Merthyr Tydfil
Mid Glamorgan
Mid Ulster
Mid and East Antrim
Midlothian
Monmouthshire
Moray
Na h-Eileanan Siar
Neath Port Talbot
Newport
Newry, Mourne and Down
Norfolk
North Ayrshire
North Lanarkshire
North Yorkshire
Northamptonshire
Northumberland
Nottinghamshire
Oldham
Omagh
Orkney Islands
Oxfordshire
Pembrokeshire
Perth and Kinross
Powys
Renfrewshire
Rhondda, Cynon, Taff
Rutland
Scottish Borders
Shetland Islands
Shropshire
Somerset
South Ayrshire
South Glamorgan
South Gloucestershire
South Lanarkshire
South Yorkshire
Staffordshire
Stirling
Suffolk
Surrey
Swansea
Torfaen
Tyne and Wear
Vale of Glamorgan, The
Warwickshire
West Dunbartonshire
West Glamorgan
West Lothian
West Midlands
West Sussex
West Yorkshire
Wiltshire
Worcestershire
Wrexham
Postal Code
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