About Katharine House: Your local Hospice

Yes, I’d like to support the work of Katharine House. 1. Your donation 2. Your payment details 4. Your Gift Aid declaration 3. Your details I would like to give I enclose a cheque payable to Katharine House Hospice OR Please debit my Visa MasterCard Card number of card (CSV) Expiry date / Data Protection: We’d love to keep you updated about our work and ways you can help, as well as sharing news and events you may be interested in. If you don’t wish to receive post from us please tick here . You can get in touch at any time to change your contact preferences. We respect your right of privacy and to have your data kept securely. We will hold your details for our own research, profiling and analysis and promise to never sell or swap these with anyone else. For our full privacy policy visit www.khh.org.uk/privacy £40 Thank You Please make my donation worth 25% more at no extra cost to me I am a UK taxpayer and I would like Katharine House Hospice to treat this donation and any donations I make in the future or have made in the past 4 years as Gift Aid donations. I understand I must pay enough income tax and/or capital gains tax each tax year to cover the amount of Gift Aid that all charities and community amateur sports clubs claim on my donations in that tax year, and I am responsible for paying any difference. I understand that any tax reclaimed will be used to support the general work of the Hospice. Please remember to let us know if your tax status, name or address change or if you wish to cancel your Gift Aid declaration. please tick Title First Name Last Name Address Postcode Last 3 digits on back £20 £10 Other IN18GEN01 About Katharine House Your local hospice Katharine House Hospice Aynho Road, Adderbury OX17 3NL Tel: (General) 01295 811 866 | Tel: (Fundraising) 01295 816 484 Email: general@khh.org.uk | Reg. Charity No. 297099 www.khh.org.uk katharinehouse khhosp How your donation could help could provide art supplies for a patient to have a creative session in our art room. could help provide a series of telephone support sessions to a teenager. could contribute to an outpatient appointment at the hospice. could help pay for one of our nurses to visit a patient in their own home. £10 £20 £40 £100 could help fund our bereavement service for one week, helping children, teenagers and adults to come to terms with the loss of a loved one. £275

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