SPONSORING THE PARISH ROOM

Thank you for sponsoring the construction of the parish room for £10.

Please complete the form below before moving on to our payment area.

Name
Postal address
Postcode
Email
Telephone
Date	12345678910111213141516171819202122232425262728293031 January February March April May June July August September October November December 2010 2011 2012
Dedication
	e.g: "This brick sponsored by..."; "This brick sponsored in memory of...". Your dedication will appear at the Buy a Brick page.
Comments
	Use Gift Aid and you can make your donation worth more. For every pound you give to us, we get an extra 28p from the Inland Revenue. To qualify for Gift Aid what you pay in UK Income Tax or Capital Gains Tax must exceed the amount we will claim in the tax year.
	Yes, please treat my donation as Gift Aid. No, I do not pay income or capital gains tax in the UK. I would prefer not to make a Gift Aid declaration.
	Thank you for completing the form. Please click the Go to Payment Area (below right) to be taken to our payment area.