The
Cardiomyopathy
Association

Making A Regular Gift

The CMA provides information such as booklets, CD Roms and posters free of charge to hospitals and clinics as well as individuals and their families affected by the condition.

We also provide funding for specialist nurses and support the delivery of quality clinical care through our regional clinics project.

To help health professionals gain a greater understanding of cardiomyopathy we organise national academic conferences.

Click here to do this on-line or press print and fill out the form below.

 Please download and print our Standing Order form here or press print and then complete the form below and send it to us at:

The Cardiomyopathy Association,
Unit 10 Chlltern Court,
Asheridge Road,
Chesham,
Bucks.
HP5 2PX

First Name_____________________________________________
Last Name_____________________________________________
Address_______________________________________________

________________________________________________________________________________

Post Code____________________

When would you like your gift to start?  Eg 05/07/2008
____/_____/______

Please enter your bank details:

Bank name_______________________________________________

Address_________________________________________________

Bank postcode _________________________

Your account number __________________________

Sort code______________________

How much would you like to give? £_______________

Every week .........Yes
Every month.........Yes
Every year ...........Yes

Pay to the account of :

CAF Bank Ltd. 25 Kings Hill Avenue, Kings Hill, West Malling, Kent ME19 4JQ, sc 40-52-40 acc no. 00003819

Are you a UK taxpayer?    Yes ___ No ___

Signed __________________________

Date _____/_____/______

Your Donation and Gift Aid!

Registered Charity Number 803262

Any donation to our charity can qualify for Gift Aid, enabling us to reclaim tax on your donation and therefore increasing its value - for example on a £100 donation, tax refunded will be £25 making the total donation worth £125.

If you are a taxpayer, sign the declaration below and your gift, and any donation you make to us in the future, will be worth a third more at no extra cost to you.

Gift Aid Declaration

I declare all donations I make on or after this date to be Gift Aid Donations

Signature________________

Date ____/_____/_____

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

Thank you for your support!

Dedicated to Damian McLoughlin, who died age 20 of cardiomyopathy. This site is supported by Damian's family and friends.