Set up a standing order

I would like to make a regular donation by standing order of
Over a year:

Please debit the above amount from my account on, or around the dates selected below and on the same day of each subsequent month until further notice (please allow one month's leeway).
Please debit my account as follows:
Please pay to the account of St Wilfrid's Hospice (Eastbourne), Barclays Bank PLC, Eastbourne Branch, Sort code: 20-27-91; Account number: 90450839
Gift Aid - If you can, please add 25% at no additional cost to you
Gift Aid
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