UCL Gift Form
Alumni Network Membership Number (if known) _____________________________________
First name(s) _________________________________________________________________
Surname
__________________________________________________________________
Address
__________________________________________________________________
__________________________________________________________________
Postcode
__________________________________________________________________
Please complete the Gift Aid section to make your gift
go further
Gift Aid
If you are a UK taxpayer you may be able to use Gift Aid. Using Gift
Aid means that for every pound you give, we get an extra 28 pence
from the Inland Revenue, helping your donation go further. If you
want to Gift Aid your donation, please complete the details below.
I want all donations I have made to the UCL Development Fund
since 6 April 2000 and all future donations to be Gift Aid until further
notice.
I would like to support
Provost’s Priority Fund – Providing support for key UCL priorities
Scholarships Fund – Awarding scholarships annually
Signature
Library Fund – Helping to maintain UCL’s world class library
Date
__________________________________________
D D MM Y Y
UCL Collections Fund – Supporting UCL’s collections
Teaching and Academic Fund – Funding new teaching initiatives and research
Friends’ Trust – Nurturing student activities such as drama, sport and music
To qualify for Gift Aid, what you pay in income tax or capital gains tax
must be at least equal to the amount we will claim in the tax year. If
you pay a higher rate of tax you can also claim tax relief by detailing
this donation in your annual tax return. See www.inlandrevenue.gov.
uk/charities for more information.
My preferred area at UCL: _________________________________________________
UCL is an exempt charity with
Inland Revenue No: X6243
please complete payment details below
Regular gift only
Data protection
I would like to give the following amount
£25
£50
£100
£500
£1,000
Other £________
My gift will be (please tick one)
Monthly
For
Quarterly
3 years
6-monthly
Annually
Other duration: ______________________________________________
Instruction to bank: Please pay UCL Development Fund, Barclays Bank Ltd
Account no 70399159 Sort code 20-10-53 from my account as detailed below:
(Office use only) quoting REF NO ______________________________________________
Name of bank ________________________________________________________________
Branch address _______________________________________________________________
_______________________________________________ Postcode: ___________________
Account no
Account holder(s) signature(s) ____________________________________________________
D D MM Y Y
Date of first payment (please allow 4 weeks)
D D MM Y Y
Single gift only
I enclose a cheque/CAF voucher made payable to UCL Development Fund
Please debit my
Visa
Visa Delta
Mastercard
Maestro
Name on card ______________________________________________________________
Card no
Expiry date
MM Y Y
Security code
Issue no
(see card reverse)
(Maestro only)
Cardholder’s signature ________________________________________________________
D D MM Y Y
Date
I would like to give the following amount
£50
Donor list
Tick here ONLY if you would prefer to be excluded from
UCL’s annual list of donors
Legacy
Tick here if you would like to receive further information
about leaving a legacy to UCL
Other gifts
Tick here if you would like to be contacted to discuss
making a gift of shares, property or land, or other gifts
to UCL
Sort code
Account holder(s) name _________________________________________________________
Date
Data Protection Act (1998): Under the confines of this act, UCL will
use the information provided by you for educational, social and
charitable purposes only. Your personal information can be removed
from the UCL alumni database within one month following receipt of
a written request from you. Please contact: Data Protection
Coordinator, Development & Corporate Communications Office,
UCL, Gower Street, London WC1E 6BT.
£100
£250
£500
£1,000
Other: £________
Thank you for your donation
Please return this form to:
UCL Futures
FREEPOST LON 5559
UCL
Gower Street
London
WC1E 6BT
No stamp is necessary in the UK
You can now update your details online at www.ucl.ac.uk/alumni