Sponsorship form Insert event name here Insert event date here

Brain tumours are the largest cancer killer of children and adults under 40, yet they receive less than 2% of funding on cancer research and survival times have improved little over the last 40 years.

Are you online?

Set up an online sponsorship page at justgiving.com/thebraintumourcharity and share it via email, Facebook and Twitter. You can also set up a text number to get donations rolling in!

The Brain Tumour Charity is at the forefront of the fight to defeat brain tumours, making a difference every day to the lives of people with a brain tumour and their families. It funds pioneering research to increase survival, raises awareness of the symptoms and effects of brain tumours and provides support for everyone affected to improve quality of life.

The Charitys goals are to double survival within 10 years in the UK and to halve the negative impact that brain tumours have on quality of life.

Find out more at: thebraintumourcharity.org

Name Address

Please help me to make a difference by sponsoring me today

Please Gift Aid your donation so we can claim Gift Aid tax relief of 25p on every pound you give at no extra cost to you. Just tick the box on your sponsorship line and dont forget to give your full home address and postcode.

If I have filled in the box headed Gift Aid? or X, I confirm that I am a UK Income or Capital Gains taxpayer. I have read this statement and want the charity or CASC named above to reclaim tax on the donation detailed below, given on the date shown.

I understand that I must pay an amount of Income Tax and/or Capital Gains Tax in the tax year at least equal to the amount of tax that all the charities and CASCs I donate to, who will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every 1 that I have given.

Home address(please give your full address or we cant claim Gift Aid)

Postcode

(essential for Gift Aid)

Gift Aid? or X

Amount paid

Tick if you dont want to hear more about The Brain Tumour Charity

Ms A Sample

1 Sample St, Sample Town

SM1 1SM

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10.00

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Date money sent to The Brain Tumour Charity:

Sponsorship form (continued)Insert event name here Insert event date here Please help me to make a difference by sponsoring me todayName Address

Full name

Home address(please give your full address or we cant claim Gift Aid)

Postcode

(essential for Gift Aid)

Gift Aid? or X

Amount paid

Tick if you dont want to hear more about The Brain Tumour Charity

Ms A Sample

1 Sample St, Sample Town

SM1 1SM

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10.00

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Subtotal (this page)

How to get the money to us

Once you have finished your event and collected all your sponsorship money you can:

1. Give our team a call on 01252 749043 to request a paying in slip to pay the money into our bank account

2. Make an online transfer to our bank account: Lloyds TSB. Account No: 50290568. Sort Code: 30-93-74. Please include REF: your name so we know its from you!

3. Send a cheque for the full amount made payable to The Brain Tumour Charity to Hartshead House, 61-65 Victoria Road, Farnborough, Hampshire GU14 7PA.

Please ensure that all donations collected offline (cash and cheques) are given to The Brain Tumour Charity in the form of one cheque or payment per participant.

If you have any queries please get in touch: donations@thebraintumourcharity.org / 01252 749043

The Brain Tumour Charity 2015. Registered Charity No. 1150054 (England and Wales) SC045081 (Scotland).