REMITTANCE FORM

To:

The Hon. Treasurer
Dorset Historic Churches Trust
The Thatched House
1, Manor Farm Close
Pimperne
Blandford DT11 8XL

I enclose herewith a donation of £................... to the funds of the Dorset Historic Churches Trust.

Name (in BLOCK CAPITALS, with title)

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

Address...................................................................................................
................................................................................................................
..................................................................Post Code..............................


GIFT AID DECLARATION

Name (in BLOCK CAPITALS, with title)

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

Address...................................................................................................
................................................................................................................
..................................................................Post Code..............................

I am a UK taxpayer, and wish all my donations to the Dorset Historic Churches Trust to be treated as Gift Aid, 
so that the Trust may claim refund of the tax I have paid on these sums.

Signed...................................................................Date............................


Please send this order and Gift Aid Declaration to:

The Hon. Treasurer
Dorset Historic Churches Trust
The Thatched House
1, Manor Farm Close
Pimperne
Blandford DT11 8XL