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Mrs
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Telephone
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Email
About the deceased
First name
*
Surname
*
Personal Message (to the family of deceased or person to be honoured)
The following message will be printed on the acknowledgement letter or you may personalise it by adding to or changing the wording.
Message
Full name:
Enter name of person(s) sending the card if different from above.
Where to post the memorial letter
Tick here if a letter is required.
If a letter is needed, please post the memorial letter acknowledgement to:
Title
*
Please select one
Mr
Mrs
Miss
Ms
Dr
Prof
Other
First name
*
Surname
*
Address
*
Address
Town/City
*
County
Country
*
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote D’ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Guiana
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Republic of
Kuwait
Kyrgyzstan
Lao Peoples Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Moldovo
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar, Union of
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norway
Oman
Pakistan
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
St. Christopher (St. Kitts and Nevis)
St. Lucia
St.Vincent and the Grenadines
Samoa
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
USA
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Yemen
Zaire
Zambia
Zimbabwe
Postcode
*
Donation
amount
*
I am making a Memorial Donation of:
£100
£50
£25
£10
£5
Other amount £
Credit card type
*
Card Type
Visa/Delta
Mastercard
American Express
Switch/Solo (Maestro)
CAF Charity Card
We are very sorry that we are unable to process Maestro (Switch/Solo) card payments at this time. We are looking into resolving this as promptly as possible and are sorry for any inconvenience this may cause. In the meantime please use another type of card to make a secure online donation.
Credit card
number
*
Issue number -
Maestro
(Switch/Solo)
cards only
(if applicable)
Start date -
Maestro
(Switch/Solo)
cards
only
(if applicable)
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2000
2001
2002
2003
2004
2005
2006
2007
Expiry date
*
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2007
2008
2009
2010
2011
Card Security
Code (last 3
digits on back of
card)
*
Name on card
*
Billing postcode
*
Telephone
*
We would like to keep you informed of the work of WCRF UK, including future campaigns. If you would rather not receive further communications, please tick this box
Gift Aid DeclAration
Under the Government's Gift Aid Scheme, if you are a UK Taxpayer WCRF UK will receive nearly a third extra on all donations you make. For example, if you give £10 to WCRF UK and Gift Aid your donation, we will receive £2.80 from the Inland Revenue at no extra cost to you.
Please tick the box if you are a UK Taxpayer and wish us to reclaim the tax paid on your donation.
I would like WCRF UK to treat all donationsI have made since 1st October 2001 and any I make subsequently as Gift Aid donations.
Please note that you must pay an amount of income or capital gains tax at least equal to the amount we reclaim in any tax year. If you are unsure if you qualify, please don't hesitate to call our Supporter Services department on 020 7343 4205.