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 - £200Mirror Will - £300Other - Please enter belowOther Amount Total £ 0.00 Name of Solicitor Firm Used:*Boys and Maughan - BirchingtonBoys and Maughan - CanterburyBoys and Maughan - MargateBoys and Maughan - RamsgateGardner CroftGirlings - AshfordGirlings - CanterburyGirlings - Herne BayMowll & MowllProsperoRobinson Allfree - BroadstairsRobinson Allfree - RamsgateStilwell & Singleton - DealStilwell & Singleton - DoverStilwell & Singleton - SandwichWhitehead MoncktonHave 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 IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin 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 supporter.relations@pilgrimshospices.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.