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Agora - Gift Aid Form

Please use this form to let us know you have made an online donation.

Payment can be made by cheque made payable to:
'Agora, the Forum for Culture and Education'.
 
Amount £
Name
Address
Postcode
Email Address
Organisation
Daytime telephone number
 
Make your gift 28% bigger at no extra cost to yourself with Gift Aid.
 
Please tick this box if you are a UK taxpayer and would like Agora to reclaim the tax on this donation and all future donations. You must pay an amount of income tax or capital gains tax equal to the tax we reclaim on your donations.
 
Registered Charity No:1115994.

Please send this completed form and payment to:

Agora: The Forum For Culture and Education
Flat 4, 512 Kings Road
London
SW10 0LD