Please use this form to make a donation

You can donate online http://www.justgiving.com/powerlistfoundation

You may also TEXT to donate
Text PLID14 10 to 70070

One off/two years/three years/until further

notice

Name Telephone
IHome
would
like to donate
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address
*
number
address*
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(Mr/Mrs/Miss/Ms/Other)*

Please let us know if your circumstances or address details change so that we can amend our
records.

Full
Make
name

your gift worth even more, withoutDat

e costing you a penny.

Do you pay tax? If so, by simply completing this form the tax

Please
cheques
payable
to you
Powerlist
office make
will give
us 25p for
every 1
donate. Foundation and return this form with your
gift to:
I am a UK tax payer and I would like the Powerlist Foundation to treat all donations I
have made for the four years prior to this year and all donations I make in the future
as Gift Aid Powerlist
donations until
I
Foundation,
c/o 10 Westbury Road, Penge, London, SE20 7QL
notify you otherwise. I understand that I must have paid an amount of income tax and/or capital gains tax for each
tax year
Thank
Success
with Tomorrows
Leaders
(6 April one year to 5
April theyou
next)for
thatSharing
is at least equal
to the amount
of tax that Powerlist
Foundation claims on
my donations for that tax year.

Powerlist Foundation, registered charity in England and Wales (1138699)

A company limited by guarantee. Registered company in England and Wales (7082850).
Registered office: Powerlist Foundation, c/o Powerful Media Ltd 2nd Floor, Cumbrian House, 217 Marsh Wall, London E14 9FJ