Application Form – Telford Tree of Light

Please complete this form to let us know the name(s) of the loved one(s) that you would like to have displayed around the Telford Tree of Light.

If you’d prefer to write on a paper form please download a form to complete and send it to us with your donation (cheques payable to Telford Tree of Light, please). If you wish to remember a pet please download this form as well.

Please complete any names and address details as they are to be printed, i.e. with capital letters at the start of each name.

Please keep messages short, otherwise they may be abbreviated and/or the whole entry will be printed in a small size font.

Please use a separate application if you are entering more than 5 names.

After submitting your application please make your donation – we suggest a minimum of £5.00 per name, thank you.

Title *

Initials *

Surname *

Address Line 1 *

Address Line 2

Town / City *

Post Code *

Email *

Confirm Email

Gift Aid *

Select Yes if you want Telford Tree of Light to treat this and any future donations as gift aid donations. This confirms that you have paid at least as much UK Income Tax and/or Capital Gains Tax for the year of donation as we, and any other charities and CASCs you donate to, will claim on your donation(s). I understand that other taxes such as VAT and Council Tax do not qualify, and that the charity will reclaim 25p of tax on every £1 that I donate.

First Name to be Remembered

First Name *

Surname *

Known as (or short message)

Second Name to be Remembered

First Name

Surname

Known as (or short message) (copy)

Third Name to be Remembered

First Name

Surname

Known as (or short message)

Add More Names

Paypal Account Name or Card Holder Name if paying by card *

To enable us to link your donation to this application

Website