Thank you for supporting LSHTM
Gifts help fund scholarships, improve the student experience and contribute to our world class research and teaching.
All donations, big and small, make a dierence to our work to improve health worldwide.
Please return your completed form to: Development & Alumni Relations, London School of Hygiene & Tropical
Medicine, Keppel Street, London, WC1E 7HT
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I want to Gift Aid my donation and any donations I make in the future or have made in the past four years to the London School of Hygiene &
Tropical Medicine. I am a UK taxpayer and 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 pay any dierence. Please notify us if you want to cancel this
declaration, change your name or home address or if you no longer pay sucient tax on your income and/or capital gains.
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Single gift
I would like to give: £1,000 £500 £250 £100 £50
Other: £
I enclose a cheque payable to LSHTM.
You can also give securely online at: www.lshtm.ac.uk/donate or call +44(0)20 7299 4772.
Regular gift (UK only)
Instruction to your bank or building society to pay by Direct Debit
Service user
6 9 1 2 1 3
CAF King’s Hill, West Malling, Kent, ME19
I would like to give: £250 £100 £50 £25 £20 £10
Other: Frequency: monthly quarterly annually
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Via Direct Debit starting on the 1st 15th
month 20
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Please pay CAF re London School of Hygiene & Tropical Medicine Direct Debits from the account detailed in this
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remain with CAF re LSHTM and, if so, will be passed electronically to my Bank/Building Society.
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The Direct Debit Guarantee
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your own Bank or Building Society.
- If the amounts to be paid or the payment dates change, CAF re LSHTM will notify you at
least ten working days in advance of your account being debited or as otherwise agreed.
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guaranteed a full and immediate refund from your branch of the amount paid.
- You can cancel a Direct Debit at any time by writing to your Bank or Building Society.
Please also send a copy of your letter to: Development & Alumni Relations, LSHTM, Keppel
Street, London, WC1E 7HT.
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