Donate your birthday - St Elizabeth Hospice

Fill in the form below to donate your birthday years to the hospice!

You can add a photo to your form so your picture will be displayed on our website Birthday Wall of Fame for the month, which will be displayed on our In Celebration homepage!

Enter your details and donation here:

Name(Required)
First Last
Postal address:(Required)
Street Address Address Line 2 City County Postcode
Telephone number:
Email address:(Required)
Enter Email Confirm Email
Date of Birth:(Required)
DD slash MM slash YYYY
Tell us if you have a connection to the hospice:(Required)

You may have received care yourself, had a family member or friend receive care, volunteer or attended one of our events previously.
Enter your donation amount:(Required)

Donate your birthday years or round it up!
Would you like a photo and message uploaded to our website for our special birthday wall?(Required)
- Yes please
- No thank you
You can upload a photo of you/your loved one for our online birthday wall:
Max. file size: 5 MB.
Upload file
If you would like to add a message with your photo, please type here:
Total
£ 0.00
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We would like to stay in touch with you to let you know how your support makes a difference, and other ways you can get involved. We will hold your personal information in accordance with the Data Protection Act 1998 and we will not pass on your personal information to third parties. View our privacy policy at: https://www.stelizabethhospice.org.uk/privacy-policy/
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Fill in the form below to donate your birthday years to the hospice!

Enter your details and donation here:

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