Page 5 - Ashgate Hospicecare News 2018

You can make a difference to families like Cheryl’s by dedicating a light to your loved one this Christmas.
To say thank you for your generous support, you will receive...
• Two Light up a Life stars on which you can write your very own message. You’ll then be able to keep one at home to display and then send the other one back to us to display with other dedications at the Hospice.
• A Light up a Life dedication card printed with your personal message.
• A small gift of your choice: a pin badge or a wishstring bracelet.
How to make your Light up a Life dedication....
You can make your dedication by calling us on 01246 567250
Head to our website
You, your friends and your family will also be invited to two Light up a Life switch-on ceremonies...
• Sunday 2nd December
outside the Market Hall in Chesterfield Town Centre. The switch-on ceremony will start at 6pm.
• Sunday 9th December
at Ashgate Hospicecare. The switch-on ceremony will start at 6pm.
Pop into your local Fill in the form below and send to:
Ashgate Hospicecare Ashgate Hospicecare, Ashgate Road, lightupalife.ashgatehospicecare.org.uk
shop
Old Brampton, Chesterfield, S42 7JD
Your details
Your dedication details
Loved one’s name
Your message
Your donation
Did you know that £24 could pay for a pack of children’s bereavement activity books?
Title
First Name
Surname
Address
Postcode
(We will use this only to contact you if there is a problem with your dedication)
Or debit my Card number Security code Valid from
Signature
Visa Mastercard
(last 3 digits on reverse of card)
Expiry date
Maestro
Please accept my donation of: (please tick) £100 £50 £20
I enclose a cheque / postal order (please make all cheques and postal orders payable to Ashgate Hospicecare)
or other £
(Maestro only)
Phone Number
Upon making your dedication, you will recieve a card with your message on. In this space, please write in BLOCK CAPITALS no more than 100 characters including spaces. I would like to Light up a Life for a very special person and I wish my card to read as follows:
D
D
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Y
Would you like your dedication added to our Light up a Life website? Yes No lightupalife.ashgatehospicecare.org.uk
Can we share your dedication on our social media (Facebook and Twitter)?
Privacy Statement
Yes No
YOUR PRIVACY RIGHTS: We respect your right of privacy and to have your data kept securely. We will never exchange your details or sell or rent your data to any other commercial organisation or charity. For full details of our Privacy Policy and to read our Supporter Charter please visit: www.ashgatehospicecare.org.uk. If you have any queries about our Privacy Policy please contact our Data Protection Officer either by email, telephone or in writing using these contact details:
Data Protection Officer, Ashgate Hospicecare, Ashgate Road, Old Brampton, Chesterfield, Derbyshire, S42 7JD. T: 01246 568801 E: info@ashgatehospicecare.org.uk
In addition to your card, as a token of our gratitude, you will receive a small gift. Please
select your preferred gift:
Gift Aid
A star pin badge
A wishstring bracelet
Make your gift worth at least 25% more to us with Gift Aid
Tick the box to make every £1 of your gift worth 25p more for FREE
I want to Gift Aid any donations I make in the future or have made in the past 4 years to Ashgate Hospicecare. I confirm that I am a UK tax payer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year, it is my responsibility to pay any difference.
Please notify us if you: want to cancel this declaration, change your name or home address or no longer pay sufficient tax on your income and/or capital gains.
Issue number (Maestro only) Date
D
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M
Y
Y
Date