Action against Medical Accidents (AvMA)

I'm fundraising for...

Select amount to donate

£15

£30

£50

Donate

All payments are secure & encrypted

Personal Donation Company Donation

First Name*

Last Name*

Email Address*

Postal Address * (enter manually)

Address Line 1 *

Address Line 2

Town/City *

Postcode *

County *

Country *

Yes No

Leave a Message (Optional)

Name to appear on page (Optional)

I'd like to remain anonymous to the fundraiser

All payments are secure & encrypted

Credit Card

Cover platform costs

Total amount

Gift Aid Yes, I am a UK taxpayer. Please treat all donations as Gift Aid donations. 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.