Thank you for taking part in this year's Make a Will Week. Please make your donation below. "*" indicates required fields Step 1 of 2 0% This field is hidden when viewing the formRefAmount to donate (£)* Your Will* Single Will Joint Will First person on Will - First name*First person on Will - Surname*First person on Will - Date of BirthDayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Second person on Will - Firstname*Second person on Will - Surname*Second person on Will - Date of BirthDayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Payment details... Please ensure the details below are those of the Debit or Credit Card you wish to pay with... Title* Mr Mrs Miss Ms Dr First name*Last name*Email* Phone number*Please enter your postcode and select your address*Address 1*Address 2Address 3City / Town*County*Postcode*This field is hidden when viewing the formCountry UK* About your Will... Solicitor branch**Please select*Alsters Kelley – CoventryAlsters Kelley – Leamington SpaAlsters Kelley – NuneatonAngels Solicitors LLPAskews Legal LLPBelvedere Wills & Estate PlanningBlythe Liggins SolicitorsBrindley Twist Tafft & James – CoventryBrindley Twist Tafft & James – SouthamBrindley Twist Tafft & James – WarwickHammons SolicitorsJohns Gilbert & Frankton LLPMander Hadley Solicitors – CoventryMander Hadley Solicitors – KenilworthMy Trusted Wills & Estate PlanningPenmans Solicitors LLP – CoventryPenmans Solicitors LLP – KenilworthPenmans Solicitors LLP – WellesbourneSC LegalWard & Rider Solicitors – CoventryWard & Rider Solicitors – KenilworthWard & Rider Solicitors – Leamington SpaDate of Appointment* DD slash MM slash YYYY Where did you hear about Make a Will Week?*You can select multiple Email Facebook Friends, family or word of mouth Instagram Newspaper / Magazine The Myton Hospices website Other website Post Poster Twitter Other Please tell us where*Why are you supporting Myton?* In memory Thanks for care Hospice movement Local charity Other Please let us know the first name of your loved one*Please let us know the surname of your loved one*Please let us know their relationship to you*Please tell us why you are supporting Myton*Leaving a gift in your Will... If you are planning on leaving a gift to The Myton Hospices in your Will, notifying us of your intentions is extremely helpful. This gives us the opportunity to say thank you, to plan for the future with confidence and, if you so wish, to keep you informed of the work that we do caring for patients and their families. This is confidentional to The Myton Hospices and is in no way legally binding. Will you be leaving a gift to Myton in your Will?* I have remembered Myton Hospices in my Will I have not or I am undecided I plan to leave / have left*You can select multiple A specific sum of money The residue of my estate A share of the residue of my estate A specific item We are interested to learn why you are so kindly intending to leave a gift to The Myton Hospices in your Will. If you are happy to let us know, please could you write your reason(s) belowI wish to Gift Aid my donation and increase its worth by 25% at no cost to me... I am a UK tax payer and confirm I will pay an amount of UK income tax or Capital Gains tax for each year that is at least equal to the amount of Gift Aid that all charities that I donate to will reclaim on my behalf. I understand that if I pay less Income Tax/Capital Gains Tax in any tax year than the amount claimed on my donations, it will be my responsibility to pay any difference back. * For the last four years /and any I may make in the future, until I notify you otherwise For my latest donation /and any I may make in the future, until I notify you otherwise I am NOT a UK taxpayer or do not wish to Gift Aid my donations Find out the difference your support makes... Thank you for supporting The Myton Hospices so we can continue to provide our services free of charge to people, and their families, living with terminal illnesses. We may keep in touch with you by post and phone to tell you more about our vital work and other ways you can help, including opportunities to donate, fundraise or volunteer and how your support has made a difference. By email* Yes No By text* Yes No Your privacy... We promise to do our best to keep your details safe and secure and will only process your data in accordance with the current Data Protection legislation. Our Privacy Policy explains how we keep this promise and you can read more online at www.mytonhospice.org/privacy-policy If you change your mind about hearing from us please email DSCT@mytonhospice.org or call us on 01926 358383. I accept The Myton Hospices Privacy Policy I accept Total Please select your Solicitor branch at the start of this page before moving on to the secure payment page For more information please call 01926 358 383 or email dsc@mytonhospice.org