In memory materials order

Thank you for choosing to support St. Luke’s Hospice in memory of someone special. Please complete the form below to order some of our in memory materials, including personalised funeral envelopes and a tribute fund page.

If you order envelopes, we aim to print these within 3 working days and will then post them out to you or contact you to arrange collection. If you would like us to set up an online tribute fund page for you, we’ll email details, including login details, to the email address you provide on this form.

If you have any queries, please contact a member of the In Memory team on 01268 524973 or email [email protected].

Your details

Please complete all details below.

Title

If ’other’, please specify

First name (required)

Surname (required)

Address line 1 (required)

Address line 2

Town / city (required)

Postcode (required)

Email address (required)

Phone number

Your loved one’s details

Please complete the following details about your loved one. We will use this information to update our records, personalise your envelopes and to set up your online tribute fund (if applicable).

Title

If ’other’, please specify

First name (required)

Middle name

Surname (required)

Please give your loved one’s most recent address if different to your own.

Address line 1

Address line 2

Town / city

Postcode

Your relationship to this person (e.g. They were my wife / husband / mother / father / friend etc.)

Your donation envelopes

How many envelopes do you require? (required)

If ’other’ please specify number of envelopes required

How would you like your loved one’s name to appear on the envelopes?

When is the funeral taking place (if known)?

How would you like to receive your envelopes? (required)

I would like to collect the envelopes from the Basildon Hospice (Nethermayne, Basildon SS16 5NJ)I would like to collect the envelopes from the Thurrock Hospice (Farriers Way, Bulphan RM14 3EB)Please post the envelopes out to meI do not require envelopes

An online page dedicated to your loved one

One way to raise money for a loved one is through an online tribute fund. A tribute fund is an online page dedicated to a loved one who has passed away. It’s a place where you can upload photos, display details relating to a funeral or celebration of life event, share special memories, light virtual candles and make donations in your loved-one’s name. Once a page has been created, you can share the link with friends and family who will also be able to leave messages and make donations. You can set up a tribute fund yourself at stlukesbasildon.muchloved.org. Alternatively we can arrange to set up a page for you.

Would you like to set up a tribute fund in memory of your loved one? (required)

Please set up a MuchLoved tribute fund on my behalfI will create a tribute fund myselfI would not like to set up a tribute fund at this time

Keeping in touch

We will use the contact details you provide to communicate with you in relation to your order and to confirm the amount raised in your loved one’s memory.

As a supporter of St. Luke’s Hospice, we’d love to keep in touch with our news, activities and opportunities for you to support us. We may contact you by post unless you tell us otherwise. You can update your preferences at any time by contacting [email protected] / 01268 524973.

I would also like to receive communications from the Hospice:

Via emailVia telephone

Your privacy

In accordance with the data protection act St. Luke’s Hospice will store your data securely for the purposes of administering your support and communicating with you about our work and other ways you can support us. You can read our full privacy policy at stlukeshospice.com/privacy-notice.

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