Kent in Focus entry form

Thank you for entering the Pilgrims Hospices Kent in Focus photo competition! You may enter up to four photographs using this form, with a minimum donation of £1.50 per photo.

On this page you'll tell us about yourself. You'll then be taken to a page where you can upload your photo(s).

Age group

Please select the age you will be as of 10 September 2012

Your details

Title

Your title

First name(required)

Surname(required)

Your date of birth--(required)

Address 1(required)

Address 2

Town or city(required)

County(required)

Postcode(required)

State Code

Contact details

Telephone(required)

Email address(required)

Confirm your email address(required)

I would like to receive information about Pilgrims Hospices by email

I would like to receive information about Pilgrims Hospices by post

Terms and conditions

Please read the terms and conditions of the Kent in Focus competition and then tick the box below to confirm your acceptance.

I have read and agree to the competition terms and conditions .

Once you submit this form, you'll be able to upload your photo(s) online.

Security information

Secured by SagePay

Be assured that your donation will be handled safely and securely online by our payment provider SagePay.

Gift Aid

If you are a UK taxpayer, please remember to tick the Gift Aid box. This enables us to reclaim tax on your donation, increasing its value to us at no extra cost to you. Find out more about Gift Aid