Make a Will Month Donation Form Thank you for supporting Pilgrims Hospices through Make a Will Month. Your donation will help us continue to provide this care for the next person that needs us. Thank you! I would like to donate*Single Will - £150Mirror Will - £250Other - Please enter belowOther Amount Total £ 0.00 Name of Solicitor Firm Used:*Boys and Maughan - BirchingtonBoys and Maughan - BroadstairsBoys and Maughan - CanterburyBoys and Maughan - MargateBoys and Maughan - RamsgateGardner CroftGirlings - AshfordGirlings - CanterburyGirlings - Herne BayMartin TolhurstProsperoRobinson Allfree - BroadstairsRobinson Allfree - RamsgateStilwell & Singleton - DealStilwell & Singleton - DoverStilwell & Singleton - SandwichHave you made a new Will or updating an existing Will through this scheme? Made a new Will Updated an existing Will How did you hear about Pilgrims Hospices Make a Will Month? Pilgrims Matters Email Website Social Media Poster/flyer Local Magazine Road Banner Solicitors Word of mouth Your DetailsTitle*MrDrMissMrsMsOtherOther Forename* Surname* Address* Address line 1 Address line 2 Town/City County / State Postcode Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Email address Enter Email Confirm Email Telephone*MobileI would like to receive my Thank You via* Email Post Neither Pilgrims Hospices will keep you up to date with exciting news, information and ways you can support us by post. If you would prefer not to receive information by post please tick here If you would be happy for us to contact you by email please tick here If you wish to adjust the frequency or type of communications you receive from Pilgrims, please call Supporter Relations on 01227 782062 or email us at firstname.lastname@example.org. Funds received will be used in accordance with Pilgrims Hospices vision to ensure that people with a terminal illness and their family and friends are supported and empowered to live well in mind and body until the very last moment of their life.