Online Gift Aid form Please see our Gift Aid page for more information and FAQs Your detailsTitle*-- Select title --MrMrsMsMissMxDrOtherEnter title First name* Last name* Address 1* Address 2 Town / City* County Postcode* Country* CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Supporter number (if known) Email* Gift AidGift aid declarationPlease make every £1 you give worth 25% more through Gift Aid. Say yes to Gift Aid and St Mungo’s will claim an extra 25p from HM Revenue & Customs for every £1 you donate. Please tick one of the boxes below. You can change this declaration at any time by notifying us. Can we make your donation go further with Gift Aid? Yes – I confirm I am a UK taxpayer and would like all my donations to St Mungo's (Registered Charity No. 1149085) made now, in the past four years and in the future to be treated as Gift Aid donations. I understand that if I pay less income tax and/or capital gains tax in any tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference. No – I am unable to Gift Aid my donation. Please notify St Mungo’s by calling us on 020 8600 3000 or by emailing supportercare@mungos.org if: · You want to cancel this declaration · You change your name or home address · Your tax status changes and you no longer pay sufficient income tax and/or capital gains tax If you pay tax at the higher rate you can claim further tax relief in your self assessment tax return. Contact preferencesContact preferencesYour support makes a real difference, and we’d love to keep you up to date with our news, activities and fundraising. Your details will only be used by St Mungo's – we will never sell your details to any third party for their marketing purposes. You are free to change your mind at any time. If you already support St Mungo’s, we will change how we keep in touch according to your choices below.Yes, I’d like St Mungo’s to contact me by: Email Phone SMS We would like to contact you via post in future. Please tick here if you do not wish to be contacted by post We will always store your personal details securely. We’ll use them to provide the service that you have requested, and communicate with you in the way(s) that you have agreed to. Your data may also be used for analysis purposes, to help us provide the best service possible. We will only allow your information to be used by suppliers working on our behalf and we’ll only share it if required to do so by law. For full details see our privacy policy or contact supportercare@mungos.org.Thank you so much for your support