Make a donation in memory

Thank you for taking the time to make this donation. Donations given in memory of a loved one, or instead of flowers at a funeral, ensure that The Stroke Association can continue in its mission to prevent strokes, and reduce their effect through providing services, campaigning, education and research.

Please complete the following form:- (Fields marked with a * are mandatory)

Your Title:

* Full Name:

* Address:

* Postcode:

* Country

* Telephone Number:

* Email Address:

* Amount to donate:

In memory

Name of deceased:

Relationship to deceased:

Would you like the next of kin to be notified of your donation?:

Yes No

* Name of next of kin:

* Address:

* Postcode:

Country:

Telephone Number:

Email Address:

Gift Aid

Every gift of £10 can now be worth an extra £2.82. The gift aid scheme allows us to reclaim tax on every donation, whatever the amount. If you pay annual income or capital gains tax equal to the tax The Stroke Association will reclaim please tick the box below.

I would like my gift to work even harder for The Stroke Association by ensuring the taxman can add his contribution too. I instruct The Stroke Association to treat all donations I make as Gift Aid donations, until I tell you otherwise.

Date

Data Protection

The Stroke Association would like to keep you informed about the work we are helping to make possible. If you would prefer us not to contact you, please tick this box

We will sometimes allow other organisations whose aims are in sympathy with our own to contact our supporters. If you do not wish to hear from these organisations, please tick this box

Are you happy for us to send you information about The Stroke Association's work by email? Please tick this box to say 'Yes'

View our terms and conditions.