Receipt Requestihsan global relief2012-09-15T14:25:01+00:00 My Details Please fill in your personal details below. Once we have received your donation, we will send you a receipt. * denotes required fields. Name appearing on bank statement*: Amount Donated*: I am a UK taxpayer and would like to increase my donation by 25% under the Gift Aid scheme at no extra cost to me. Your Title*MrMsMissMrMasterDrProfHon First Name* Surname Name* Your Email* Address*: —Please choose an option—AKALARAZCACOCTDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY US State (United States address only)UNITED KINGDOMÅLAND ISLANDSALBANIAALGERIA *AMERICAN SAMOAANDORRAANGUILLAANTARCTICA *ANTIGUA AND BARBUDAARGENTINAARMENIAARUBAAUSTRALIAAUSTRIAAZERBAIJANBAHAMASBAHRAINBANGLADESHBARBADOSBELGIUMBELIZEBENINBERMUDABHUTANBOSNIA-HERZEGOVINABOTSWANABOUVET ISLAND *BRAZILBRITISH INDIAN OCEAN TERRITORY *BRUNEI DARUSSALAMBULGARIABURKINA FASOCANADACAPE VERDECAYMAN ISLANDSCENTRAL AFRICAN REPUBLIC *CHILECHINACHRISTMAS ISLAND *COCOS (KEELING) ISLANDSCOLOMBIACOOK ISLANDSCOSTA RICACYPRUSCZECH REPUBLICDENMARKDJIBOUTIDOMINICADOMINICAN REPUBLICECUADOREGYPTEL SALVADORESTONIAFALKLAND ISLANDS (MALVINAS)FAROE ISLANDSFIJIFINLANDFRANCEFRENCH GUIANAFRENCH POLYNESIAFRENCH SOUTHERN TERRITORIESGABONGAMBIAGEORGIAGERMANYGHANAGIBRALTARGREECEGREENLANDGRENADAGUADELOUPEGUAMGUERNSEYGUYANAHEARD ISLAND AND MCDONALD ISLANDS *HOLY SEE (VATICAN CITY STATE)HONDURASHONG KONGHUNGARYICELANDINDIAINDONESIAIRELANDISLE OF MANISRAELITALYJAMAICAJAPANJERSEYJORDANKAZAKHSTANKIRIBATIKOREA, REPUBLIC OFKUWAITKYRGYZSTANLATVIALESOTHOLIECHTENSTEINLITHUANIALUXEMBOURGMACAOMACEDONIAMADAGASCARMALAWIMALAYSIAMALTAMARSHALL ISLANDSMARTINIQUEMAURITANIAMAURITIUSMAYOTTEMEXICOMICRONESIA, FEDERATED STATES OFMOLDOVA, REPUBLIC OFMONACOMONGOLIAMONTENEGROMONTSERRATMOROCCOMOZAMBIQUENAMIBIANAURUNEPAL *NETHERLANDSNETHERLANDS ANTILLESNEW CALEDONIANEW ZEALANDNICARAGUANIGERNIUENORFOLK ISLANDNORTHERN MARIANA ISLANDSNORWAYOMANPALAUPALESTINEPANAMAPARAGUAYPERUPHILIPPINESPITCAIRNPOLANDPORTUGALPUERTO RICOQATARREUNIONROMANIARUSSIAN FEDERATIONRWANDASAINT HELENASAINT KITTS AND NEVISSAINT LUCIASAINT PIERRE AND MIQUELONSAINT VINCENT AND THE GRENADINESSAMOASAN MARINOSAO TOME AND PRINCIPE *SAUDI ARABIASENEGALSERBIASEYCHELLESSINGAPORESLOVAKIASLOVENIASOLOMON ISLANDSSOUTH AFRICASOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDSSPAINSURINAMESVALBARD AND JAN MAYENSWAZILANDSWEDENSWITZERLANDTAIWAN, PROVINCE OF CHINATANZANIA, UNITED REPUBLIC OFTHAILANDTIMOR-LESTETOGOTOKELAUTONGATRINIDAD AND TOBAGOTUNISIATURKEYTURKMENISTANTURKS AND CAICOS ISLANDSTUVALUUGANDAUKRAINEUNITED ARAB EMIRATESUNITED KINGDOMUNITED STATESUNITED STATES MINOR OUTLYING ISLANDSURUGUAYUZBEKISTANVANUATUVENEZUELAVIET NAMVIRGIN ISLANDS, BRITISHVIRGIN ISLANDS, U.S.WALLIS AND FUTUNAWESTERN SAHARAZAMBIA Contact Number*: Δ