Donate by Bank Transfer "*" indicates required fields Thank you for wishing to make a donation to Pilgrims Hospices via bank transfer. Once you have submitted this form, you will receive our bank details via email Your detailsName* Title DrMissMrMrsMsMxProf.Rev. Forename Surname Address* Address Line 1 Address Line 2 Town/City County Postcode Email Enter Email Confirm Email If you would be happy for us to contact you by email please tick here If you would prefer not to receive information by post please tick here Your Donation Intended Donation Amount*By letting us know the amount you intend to send us, we can better identify your donation when received. Reason for Donation*General DonationIn MemoryPay in money raisedIn lieuOther Name of person your donation is in memory ofPlease provide details of the celebration you are donating in lieu ofFor which event was this money raised forOther reasonI would like to receive my Thank You via* Email Post Neither Gift Aid - Increase the value of your gift by 25% Yes. Please treat all donations I make now, and in the future, or have made to Pilgrims Hospices for the past 4 years as Gift Aid donations until further notice. I am a UK taxpayer and understand that if I pay less income Tax and/or Capital Gains Tax in the current tax year then the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference. I understand that Pilgrims Hospices will reclaim 25p of tax on every £1 that I have given. I am not a UK taxpayer