Thank you so much for choosing to make a regular gift to Chestnut Tree House

Regular Amount
For administration reasons, no less than £5 per month or equivalent please.
First Payment Date:
For every pound you donate to Chestnut Tree House, we can collect an extra 25p from the tax man. To help us raise more funds, please tick the box to confirm you wish to Gift Aid your donations..

I am a UK Income or Capital Gains taxpayer. I have read this statement and want St Barnabas Hospices (Sussex) Ltd to reclaim 25p of tax on every £1 that I have given on this date, in the past 4 years and in the future. I understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year, it is my responsibility to pay any difference.
No, I am NOT a UK tax payer, or do not pay sufficient tax.
Please notify Chestnut Tree House 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 Tax

Personal Details
Bank Details
Chestnut Tree House
2 Titnore Lane
West Sussex
BN12 6NZ


For any queries contact our Supporter Care No: 01903 706329

You will need your account details, which can be found on your cheque book or bank statement, to complete the direct debit instruction. Is the account in your name? Are you the only signatory required to authorise this direct debit? If not, please click here for a paper mandate (PDF format) which should be printed off and sent to us with all necessary signatures.

Registered Charity Number 256789

Service User Number 693186