"*" indicates required fields Your Name:* First Last Address* Street Address Town/City County Postcode Your email:* Contact Phone Number:Where would you like your Gift Card sent?* Send to me Send to them Recipients Name:*Recipients Address:* Street Address Town/City County Postcode Message to be written in card:*Please select the Gift/s you would like:WOULD YOU LIKE TO SUPPORT OUR MEDICAL WORK?*This is perhaps the most important aspect of our work and is reflected in our title - Health Help International. It naturally consumes a large proportion of our income. Yes No A visit to a physiotherapist (M01) Quantity Price: £ 5.00 Quantity A month's help with the cost of medicines (M02) Quantity Price: £ 10.00 Quantity Zimmer frame (M03) Quantity Price: £ 10.00 Quantity A week's supply of nutritious food for malnourished children in Monze Mission Hospital(M04) Quantity Price: £ 15.00 Quantity 12 packs of diapers for an incontinent patient (M05) Quantity Price: £ 20.00 Quantity Wheelchair repair (M06) Quantity Price: £ 20.00 Quantity A week's dialysis (3 visits) (M07) Quantity Price: £ 25.00 Quantity Nursing support at Thanal House for a month (M08) Quantity Price: £ 40.00 Quantity Cost of attending specialist hospital appointment (M09) Quantity Price: £ 60.00 Quantity Medical Camp in Orissa (M10) Quantity Price: £ 80.00 Quantity Wheelchair (M11) Quantity Price: £ 100.00 Quantity Nursing assistant - costs for a month (M12) Quantity Price: £ 120.00 Quantity WOULD YOU LIKE TO SUPPORT WORK IN THE COMMUNITY?*We have a number of projects in progress in India and Zambia that require ongoing funding and/or materials to maintain their viability. We also seek to provide little ‘extras’ for children in particular. Yes No Food for a family with a disabled member for one month (C01) Quantity Price: £ 10.00 Quantity One week's pay for an animator (facilitator) of credit unions/self-help groups (C02) Quantity Price: £ 13.00 Quantity Support one person for a month at Thanal House (C03) Quantity Price: £ 20.00 Quantity Sewing Machine (C04) Quantity Price: £ 40.00 Quantity One month's salary for sewing teacher (C05) Quantity Price: £ 70.00 Quantity Pit latrine (C06) Quantity Price: £ 120.00 Quantity Well (C07) Quantity Price: £ 250.00 Quantity WOULD YOU LIKE TO SUPPORT WORK IN EDUCATION?*School pupils and older students need support for all aspects of their education: fees, clothing, equipment, etc. In addition, new teachers need to be trained. Yes No Gift for a child (E01) Quantity Price: £ 5.00 Quantity Educational materials for special needs children (E02) Quantity Price: £ 5.00 Quantity Menstrual hygiene packs for schoolgirls (E03) Quantity Price: £ 10.00 Quantity Midday meal at Muumba Primary School for every child (E04) Quantity Price: £ 20.00 Quantity Food at a special needs school for everyone for a week (E05) Quantity Price: £ 40.00 Quantity One term's residential fees for a disabled child in Zambia (E06) Quantity Price: £ 70.00 Quantity One year's residential fees for a disabled child in Zambia (E07) Quantity Price: £ 210.00 Quantity WOULD YOU LIKE TO SUPPORT WORK IN AGRICULTURE AND SELF SUFFICIENCY?*Good food is one of the keys to good health. The gifts in this section will help many people enjoy the benefits of growing vegetables and fruit or rearing their own animals for food and/or milk. Yes No Seeds & Fertilizer (A01) Quantity Price: £ 10.00 Quantity Coop and chickens (A02) Quantity Price: £ 30.00 Quantity A Goat (A03) Quantity Price: £ 80.00 Quantity A Calf (A04) Quantity Price: £ 200.00 Quantity A Cow (A05) Quantity Price: £ 400.00 Quantity Irrigation System (A06) Quantity Price: £ 700.00 Quantity I would like to select my own level of donation for general funds (G01): Please put in your amount you would like to donateTotal GIFT AID I pay income tax and would like to increase my donation by around 25%I would like Health Help International to treat my donation as a Gift Aid donation. Declaration: I am a UK taxpayer and 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.Credit Card Cardholder Name Card Details
