Donate
Thank you for supporting Hospiscare
Your donation amount:
Your name
*Title:
*First name:
*Last name:
Phone:
Your card billing address
*Address line 1:
Address line 2:
*City:
*Postcode:
*Email address:
By providing us with your email address you are agreeing to be contacted in this way. You can opt-out of receiving updates from us below.
THE REASON FOR YOUR DONATION
*Please select one option:
*Please tell us why you held this event:
*Name of company:
*Name of Event:
Please tell us about your donation:
Name:
Relationship to you:
Using your information

Supporters of Hospiscare are precious and we will not sell your details onto anyone else. We would like to keep in touch with news about our work and fundraising activities. If you DO NOT wish us to contact you by the following means please tick the relevant box:

Phone

Mail

Email

Gift AID your donation

If you are a UK taxpayer we are able to claim an extra 25p for every £1 you donate. On the next page please read the Gift Aid statement and tick if you are eligble for Gift Aid to be claimed from your donation.

Volunteer Application Form

Personal details
Preferred Title:
First name:
Surname:
Address:
Date of Birth:
Email:
Work tel:
Home tel:
Mobile tel:
In case of emergency
Contact name:
Contact tel:
Contact Address:
How did you hear about Hospiscare?
Reference 1
Reference 1 Name:
Telephone
Address line 1
Address line 2
Town
County
Postcode
Email
How long have they known you?
In what capacity?
Reference 2
Reference 2 Name:
Telephone
Address line 1
Address line 2
Town
County
Postcode
E-mail
How long have they known you?
In what capacity?
Additional information
Please briefly state your reason for applying to be a Hospiscare volunteer and outline any past experience that is relevant:
I consent to the use of my personal data in the way described above:
Do you consider yourself to have a disability?
If yes, please tell us below what reasonable adjustment(s) you would require to the workplace to perform the role effectively and let us know if you have any special requirements with regards to the assessment process:
What role are you interested in volunteering? Eg. driving, gardening etc. (see a list of various roles on the website page). What days and times are you available?