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Title (eg. Mrs)

First Name or initials*

Surname*

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Email address *

Company (optional)

 I wish to remain anonymous.

You can give someone with additional support needs the chance to:

 10 25 50

Number of cards you would like to purchase?

Send card via email or by post? via Emailvia Post
(postage=additional £1 per card)

If you check the Gift Aid opt-in box below you are confirming that you have paid or will pay an amount of Income Tax and/or Capital Gains Tax for the current tax year (6 April to 5 April) and it is at least equal to the amount of tax that Paragon will reclaim on all my gifts to them for the current tax year. You understand that other taxes such as VAT and Council Tax do not qualify. You understand the charity will reclaim 25p of tax on every £1 that you have given.

 I am a UK taxpayer and I wish to treat my donation as a Gift Aid donation.

PLEASE NOTIFY PARAGON ENSEMBLE IF YOU:

• Want to change this declaration
• Change your name or home address
• No longer pay sufficient tax on your income and/or capital gains