Dedicate a light to someone special

Please provide us with a few details about your dedication.

• • Do you require a limited-edition tree decoration? *
  • I would like a limited-edition tree decoration
  • I do not require a limited-edition tree decoration
• • Would you like your thank you card sent via email or in the post?
  • Via email
  • In the post

• • £20

    • donation to help the Hospice this winter
  • £50

    • donation to help the Hospice this winter
  • £100

    • donation to help the Hospice this winter
  • £300

    • donation to help the Hospice this winter
  • Other amount
    £

• The name of my dedication(s) *

• • Are you happy for your loved one's name(s) to be included in the order of service? *
  • Yes, I'm happy
  • No thank you

• • Are you happy for your loved one's name(s) to be displayed at the event? *
  • Yes, I'm happy
  • No thank you

• • Which tree would you like your loved one's light on? *
  • Hospice
  • Top of town
  • Festival Place
  • Hook
  • Overton
  • Alton
  • Four Marks
  • Whitchurch

• • Would you like to know more about our Memory Tree? *
  • Yes please
  • No thank you

• • Gift Aid my donation to earn 25p for every £1 donated
  • Yes please
  • No thank 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 St. Michael’s Hospice (North Hampshire). 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. Please notify us if you wish to cancel this declaration, change your name or home address or no longer pay sufficient tax on your Income and/or Capital Gains. If you pay Income Tax at a higher or additional rate and want to receive additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.