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YOUR DETAILS

Title*

First Name*

Last Name*

Email*

Phone*

Details of the departed

Relationship*

First Name*

Last Name*

Date of birth

Date of death

Photo

Accepted file types: jpg, gif, png, Max. file size: 5 MB.

Candle choice

Your Name

If you so wish, please type your name/s here, to identify who lit this candle. If you leave it blank, nothing will appear

Message*

Memory wall

Price:

CODE

If you have been given a CODE, please enter it here, and you will not be charged

Would you like to make an additional donation?

Yes
No

Please add the amount below

GIFT AID - Are you a UK taxpayer? Turn your gift 1.25X times at no extra cost for you.

I want to Gift Aid my donation and any donations I make in the future or have made in the past 4 years, to Grief Encounter. 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 of my donations in that tax year it is my responsibility to pay any difference. Grief Encounter will claim 25p on every £1 donated. Gift Aid cannot be reclaimed if you are paying in other people’s donations or donating on behalf of a company.

Yes, I would like Grief Encounter to claim Gift Aid on my donation.

Address*

Street Address Address Line 2 City Postcode

Total

£ 0.00

SECURITY & PRIVACY

We use secure transmission and will never sell your information to a 3rd party.

We can only continue to help bereaved children, young people and their families through the passion and generosity of our valued supporters. We’d love to stay in touch and keep you updated with information on our projects and services, including events and fundraising activities. Rest assured we will never share your data with third parties. You can change the way you hear from us at any time by emailing us at contact@griefencounter.org.uk or calling us on 020 8371 8455. You can read more about how we use your information by visiting our privacy policy.

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Memorial Wall

YOUR DETAILS

Details of the departed

SECURITY & PRIVACY