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St. Clare’s hosts an annual Tree of Lights service in the grounds of the Hospice. We extend an invitation for you
to join us and remember a loved one by dedicating a light on our Tree of Lights.
Your Dedication
I wish to dedicate a light in memory of:
First Dedication
Second Dedication
Third Dedication
(If you have more dedications, please write them on a separate sheet and attach to this form)
Your Details
Name:
Address:
Postcode:
Tel No:
(Please note that these details will not appear in the book of lights and are for administration purposes only)
Your Payment Details
I enclose a cheque for £
(Please make cheques payable to St. Clare’s Hospice)
OR
Please debit the amount of £ from my credit/debit card
(please delete as appropriate)
PLEASE NOT THAT YOUR CARD DETAILS WILL NOT BE
RETAINED FOR ANY FURTHER TRANSACTIONS
Expiry Date: /
Start Date: /
Issue No:
Card Security Code:
(if present)
Name as it appears on card:
Card Issuer:
Card Type:
(eg. Visa, Maestro)
Gift Aid Declaration
For past, present & future donations
Please treat as Gift Aid donations all qualifying gifts of money made
Today in the past 4 years in the future
Please tick all boxes that apply
I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains
Tax for each tax year (6th April to 5th April) that is at least equal to the amount of
tax that St. Clare’s Hospice will reclaim on my gifts for that tax year. I understand
that other taxes such as VAT and Council Tax do not qualify. I understand the
charity will reclaim 25p of tax for every £1 that I give on or after 6 April 2008.
Signed Date
Please notify us if you:
• Want to cancel this declaration
• Change your name or home address
• No longer pay sufficient tax on your income and/or capital gains.
Please return your gift aid declaration using our freepost address:
Freepost RSYL-BASZ-GTXR, St Clare’s Hospice,
Primrose Terrace, JARROW, NE32 5HA
Light up a life this Christmas…
On Sunday, 13th December we will be holding a service with
carols. We hope to make the event as special as possible for
those who attend; therefore, you are invited to attend a service by
surname of your dedication, as follows:
4.30pm Surnames A-M
6.00pm Surnames N-Z
The Tree of Lights will be switched on at the end of each service
and they will stay illuminated until the New Year.
Your gift will dedicate a light on our tree to someone special. Their
name will appear in our Tree of Lights book, which will be on
display at the service and then in our chapel. You are welcome to
view the book at any time.
To dedicate a light please complete the dedication form and return
to the Fundraising Office, St. Clare’s Hospice, Primrose Terrace,
Jarrow, NE32 5HA. Please note that a souvenir programme will be
given to all who attend either service. The name of your dedication
will be recorded in the programme.
To ensure your dedication is entered please return your form by
1st December. Unfortunately, forms received after this date will
not be entered into the programme but will still be entered into our
Tree of Lights book.
Any names received after Thursday, 10th December will not be
entered into the Tree of Lights book until after the service.
