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Hang a stunning leaf on our tree, engraved with a dedication of your choosing as a lasting tribute to a loved one or as a message of thanks.

Your leaf will stay on our tree for a year, before we offer you the option to renew for another year or have the leaf presented to you to treasure forever.

Additional leaves can be purchased for your family,which will be given to you in a keepsake box.

Engraved leaves can be purchased for a donation of £49 or more. Additional leaves can be purchased for a donation of £29 or more each. These leaves will be engraved and sent to you in a presentation box to keep forever.

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Charity No: 1011117

All proceeds support the work of St Andrew’s Hospice

Tree donated by:

Name

Tel Number

Date

*Must have full address & post code*Must also be the address to which the card is registered

Leaf Finish

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Or��� F���

Address

Message

Credit Card or Switch

3 Digit Security Number

Card Number

Expiry Date

Issue No

Start Date (If applicable)

From signature strip

(If switch or Maestro)

Total Amount £

1st Line : 22 letters2nd Line: 22 letters3rd Line: 23 letters

Additional Keepsake Leaf (quantity & colour)

Rose Gold White Gold Yellow GoldPlease tick

Payment can also be made via cheque or cash at reception