Registered Charity No 1190391

Boost your donation by every 25p of Gift Aid for every £1 you donate!

Gift Aid is reclaimed by the charity from the tax you pay for the current tax year.

Your address is needed to identify you as a current UK tax payer.

In order to Gift Aid your donation you must tick the box below:

[ ] Yes, I want to Gift Aid aid any donations I make in the future or have made since 1 January 202 0 to Intermission Youth.

If you would like to only Gift Aid this donation, please tick this box too [ ].

I am a UK tax payer and I understand that if I pay less Income Tax and/or Capital Gains tax in the current tax year than the amount of Gift Aid claimed on all my donations, it is my responsibility to to pay any difference.

Please print out and use black ink to complete in BLOCK CAPITALS

Please send completed form to Intermission Youth, 24 Greencoat Place, London SW1P 1RD


First name or initials:

Last name:

Full home address:




Please notify us if you:

​ * want to cancel this declaration

​* change your name or home address

​* no longer pay sufficient tax on your income and/or capital gains

If you pay Income Tax at the higher or additional rate and want to receive the additional

​tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment

tax return or ask HM Revenue and Customs to adjust your tax code.

GDPR: The information you supply will be treated by us in confidence in accordance with the General​ Data Protection Regulation and will not be passed to any third parties. From time to time we may contact you with details of events and activities associated with the charity.

Intermission Youth

Registered office: 24 Greencoat Place, London SW1P 1RD