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| Please indicate level of injury if applicable: | |||
| New Membership: £3.00 | |
Renewal: £3.00
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(First year FREE if spinal cord injured)
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| *I would like this donation to be treated as Gift Aid | |
| *I would like all the donations I make to INSPIRE be treated as Gift Aid | |
| *I would like the donation I made on ..../..../.... to be treated as Gift Aid | |
| *I would like all the donations I have made since 6 April 2000 and all donations I make from the date of this declaration until I notify you otherwise to be treated as Gift Aid |
*Please see notes on Gift Aid Declaration
| Signature ________________________ | Date ____ /____ /____ |
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Please make cheque/PO payable to INSPIRE Please print off, complete and send to The INSPIRE Foundation Tel: 01722 336262 extension 2465 Registered Charity: 29628 |