Tree of Memories

If you would like to honour someone you love by placing a leaf or sunflower on Kirkwood’s Tree of Memories, please complete the form below. If you would like to order more than one leaf or sunflower, please complete a separate form for each item.

About you

Contact details

Choose your leaf

Boost your donation by 25p of Gift Aid for every £1 you donate

Gift Aid is reclaimed by Kirkwood Hospice from the tax you pay for the current tax year. Your address is needed to identify you as a current UK taxpayer.

In order to Gift Aid your donation, you must tick the box below:

Thank you for Gift Aid!

Choosing to Gift Aid your donation means we will now receive an additional £1.25 from HM Revenue and Customs at no extra cost to you.
Declaration: 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 Kirkwood Hospice 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

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.

Your Inscription

Please engrave the following name or message on my leaf.

Inscriptions on a leaf or flower can consist of 15 characters per line, including spaces, up to a maximum of 4 lines

Keeping in touch

We will use your address to send you news about Kirkwood Hospice, how your support helps patients and families and other ways in which you could help, unless you tell us not to by contacting our Fundraising Team on 01484 557911 or emailing: fundraising@kirkwoodhospice.co.uk