Response Form

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Download Smile Response Form A5 PDF (69 KB) or print this page.

SMILE INTERNATIONAL

Donation

.....  I/We* would like to support Smile International and enclose my/our* gift of £ ....................

Acknowledgement required  YES .....     NO .....
To save on administration costs, gifts under £10 are not acknowledged.

We also accept donations by:

MASTERCARD .....     VISA .....     SWITCH  .....     SOLO .....     DELTA .....

Card No.                                                                                                                                

 

Expiry Date                  /               Start Date                  /               Issue No. (Switch Only)                

Amount to be debited £ .....................   Name on Card (Please print) .......................................................

Cardholder's signature .......................................................   Date .....................................

In order to process your credit card donation we require your 3-digit security number. Please provide your contact number for this purpose only:

Tel .......................................................................................
Gift Aid Declaration   Please fill in for one person only

I am a UK tax payer and I would like Smile International to treat all donations I have made as well as any future donations as Gift aid until I notify them otherwise.

YES .....     NO .....

I understand that I must have paid an amount of tax or capital gains tax at least equal to the amount of tax that the charity will claim in the tax year.

Signature .................................................   Date ...........................................................
Your Details (PLEASE PRINT)

Title .........................  Surname ........................................................................................

Forename(s) .....................................................................................................................

Address .............................................................................................................................

..........................................................................................................................................

Postcode ...........................................................................................................................

Telephone ........................................................................................................................

Email ................................................................................................................................

Church/Organisation/School attending ....................................................................................

..........................................................................................................................................
Regular Giving

.....  I/We* would like to support Smile International on a regular basis.

Please pay: HSBC Bank plc, 9 Station Square, Petts Wood, Orpington, Kent, BR5 1LR
For account of Smile International, Sort Code 40 36 17 Account Number 61369113

the sum of £ ..................     every     month .....     year .....

starting on (date)     .....   .....  /  .....   .....   /   .....   .....     until further notice.

To (name of your bank) .......................................................................................................

At (your bank's address) .....................................................................................................

..........................................................................................................................................

Name of Account Holder(s) ..................................................................................................

Your Bank Sort Code   ........................................................................................................

Your Bank Account Number   ..............................................................................................

Signature ................................................................   Date ................................................

(for sponsoring a Child or Widow, please use the form in the appropriate leaflet)

Mailing List

..... Please update my details as above (please include old details, including postcode)

..... Please add me to your mailing list (Please send .......... copies of the Smile Magazine/Update every mailout)

......Please send no Magazines/Updates, I receive these from other sources

..... Please delete me from your mailing list

Literature Please send me:

..... Sponsor a Child leaflet

..... Sponsor a Widow leaflet

..... Shoebox leaflet

..... Alternative Gifts catalogue

..... Ministry Trips/Career Break brochure

..... Gap Year brochure

..... Aid Guidelines leaflet

..... Merchandise leaflet

..... Legacy Giving leaflet

I am interested in ...

..... Having a Smile speaker (please give details of your requirements)

..... Becoming a Smile collection point for aid/shoeboxes

..... Becoming a Smile Local Coordinator

..... Becoming a Volunteer

..... Becoming a Friend of Smile Centre Kosova

..... Please add me to your Prayer Partner list for monthly prayer calendar

  • By post  .....

  • By email to .....................................................................................................

(Choosing the email option will help to save our costs. Thank you.)

Smile literature and prayer calendar are also available as downloads from the Resources page

Thank you for your support. Please post completed form to:
Smile International, PO Box 3, Orpington, Kent, BR5 1WZ, UK
 Registered Charity No. 1079730 (RF/07/06)
 
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