Lights of Love | RSVP to our special remembrance service

Complete this form to remember someone special and support Sobell House.

Step 1: Your Details

Title*

First name*

Surname*

Address Line 1*

Address Line 2

Town*

County

Country*

Postcode*

Step 2: Your dedication

Will you be attending Lights of Love?

Yes, I will be taking part virtually. Please send me a Lights of Love at Home pack. Not this time
We are no longer able to accept online sign ups to attend the event in person. To register please instead call 01865 857007 or email us.

Please tell us the name of the person(s) who you wish to dedicate a light of love to.

Please note that the deadline for us to be able include the name of your loved one during the service has now passed, but if you add it here then we will still keep a record of your dedication.

Step 3: Choose your donation amount

If you aren't able to make a donation, you can still register to attend Lights of Love by calling the Charity team on 01865 857007 or by emailing [email protected]

£33

£65

£150

£600

£1000

£33

which is enough to train a new telephone companion volunteer so they can give vital support and companionship to patients.

£65

which could cover the cost of bereavement counselling for someone struggling with grief and loss.

£150

which is enough to pay for a Palliative care consultant to assess a patient at home and help with their pain and symptom control.

£600

which is enough to pay for a full day and night of care for a patient on our specialist In-patient Unit.

£1000

a wonderful gift which could pay for a syringe pump that releases pain medication to a patient who can't swallow tablets, ensuring they're pain-free and comfortable.

Or your own preferred gift of

Step 4: Payment Details

Card Number*

Expiry Date (mm/yy)*

Security Code*

Step 5: Gift Aid

I want all donations I've made to you in the past four years and all donations in future to be treated as Gift Aid donations until I notify you otherwise.
I am a UK taxpayer 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.
I will notify Sobell House if I no longer wish for you to claim Gift Aid on my donations, or if my name or address changes.
We will claim 25p on every £1 you donate.

Yes I would like you to claim Gift Aid on my donation

Step 6: Contact information

Email*

Phone

Can we keep in touch to tell you how your support is making a difference and about other ways you can help, including opportunities to donate, volunteer or fundraise?

Email

Phone

Post

If you'd like to change how we keep in touch, call 01865 857007 or email [email protected]. We promise to keep your details safe and only use them in accordance with our privacy policy.