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Header Details

Yes, I want very much to help fight eye disease and save the sight of thousands of patients

Donation Details

Donation Details (*required field)

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Amount :

Currency: *

Amount:

Amount Radio:

100

Amount: * or state an amount *

Appeal (if applicable): *

Donation type: *

Personal Details

Personal Details (*required field)

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Firstname: *

Surname: *

Address (line 1): *

Address (line 2):

Address (line 3):

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Gift Aid Details

Gift Aid:

Please tick this box so that we can claim 25p from the Government for every £1 you donate – at no extra cost to you (UK Taxpayers only)

Information Email:

Please tick if you would like us to send you information on the Eye Hospital from time to time. We will not pass your details onto third parties.

Letter Acknowledge:

Please tick if you require an additional acknowledgement letter by post.

Gift Aid Notes

You must pay an amount of income tax and/or capital gains tax at least equal to the tax that all charities or CASCS that you donate to will reclaim on your gifts in the tax year (currently 25p for each £1 you give).
If in the future your circumstances change and you no longer pay income tax / capital gains tax equal to the tax we reclaim, you can cancel this declaration.
You may cancel this declaration at any time by notifying us – it will then not apply to donations you make on or after the date of cancellation or such later date as