GIFT AID DECLARATION

I would like to make a donation to Association of Dental Implantology using Gift Aid. My details are:

I would like to Gift Aid all donations I've made to Association of Dental Implantology since 6 April 2004 and all donations in the future until I notify you otherwise.

To qualify for Gift Aid, what you pay in income tax or capital gains tax must at least equal the amount the charity will claim in the tax year.

Please complete and return this form to the:

Association of Dental Implantology
98 South Worple Way, London, SW14 8ND
Registered Charity Number: 800238