Please complete this form, then print and return to: Cross Rhythms, PO Box 1110, Stoke-on-trent, ST1 1XR
(UK only. If you live outside the UK and would like to give to Cross Rhythms please use our one-off donation page)

Becoming A Friend of Cross Rhythms
Title:
Name:
Address:
Postcode:
Telephone:
Email:
Bank Standing Order Mandate
Name:
Name of Bank:
Full bank address
Postcode:
Account Number:
Sort Code:
Please Deduct
£10.00 £25.00 £50.00
per month or other amount of: £
From the above account on (date) and then monthly until further notice from my/our above account.
Pay this sum to: Cross Rhythms. Ac No.00018685, CAF Bank LTD(40-52-40), 25 Kings Hill Ave, Kings Hill, West Malling, Kent, ME19 4JQ.
Signed
Date
I/We understand that I/We am/are free to cancel this commitment at any time.
For Bank use only:
Customer/payment Reference:
Gift Aid Declaration

I am a UK tax payer and want Cross Rhythms to reclaim the tax on all my donations made in the past 6 years and all future gifts of money that I make from the date of this declaration. I will advise Cross Rhythms if this situation changes. (You must pay an amount of income or captial gains tax at least equal to the tax that the charity reclaims on your donations in the tax year.)
Signed
Date
For more information you can contact:
admin@crossrhythms.co.uk - Tel: 01782 251000
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