Application Form

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

If you'd prefer to write on a paper form please download a form and send it to us with your donation (cheques payable to Telford Tree of Light, please).

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

After submitting your application please make your donation.

Your details
Tick 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
Second name to be remembered
Third name to be remembered

Please make your donation (a minimum of £5.00 for each entry) by clicking the donate button in the menu on the left after submitting this form.